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All About Anxiety: What Teens and Young Adults Should Know

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Beth Cumming, MA, Jenna Riggs, LSW, and Emily Schrader, MSW, LSW

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Find valuable anxiety resources to help kids with anxious feelings or anxiety disorders from the Kids Mental Health Foundation. Access tools, tips, and support.

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OCD in school: A guide for students, parents, and teachers

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OCD in school: A guide for students, parents, and teachers

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OCD in school: A guide for students, parents, and teachers

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As the school year approaches, you might feel anxiety increasing, sadness encroaching in, and uncertainty taking over. The end of summer break brings up a

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Autism Society of North Carolina Resources

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Autism Society of North Carolina Resources

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Providing links to information about supports, services, and resources for individuals and families impacted by autism.

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Children with OCD have intrusive thoughts and worries that make them extremely anxious, and they develop rituals they feel compelled to perform to keep those anxieties at bay. This guide explains the often confusing behaviors that can be associated with OCD, and the treatments most effective for hel…

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Homework Guide for Parents and Caregivers

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Homework Guide for Parents and Caregivers

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Homework Help Guide from the National Autistic Society

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Learn about some of the possible reasons why your child might struggle with their homework and some strategies you can use to help your child finish their homework.

Why might your autistic child find homework hard?

Your child might be having difficulty because:

the homework does not meet their level of ability and need so they find it too difficult, become frustrated and then don't want to work at home

they don't understand why they have to do work for school when they're at home

it's not be clear to them what work needs to be done if they have difficulty with processing instructions or writing, and are not supervised when recording homework

they feel too tired after a long day at school or there may be too many distractions at home for them to concentrate

they have difficulty with organising, sequencing and prioritising tasks and may misjudge how long to spend doing homework

they feel that the work has to be perfect, and struggle to begin a task because of anxiety.

If your child has a demand avoidant profile their need to be in control may drive them to avoid the demands of homework. The PDA Society has further information, including strategies to try at home.

How to help your child with their homework

Make sure it's achievable

If your child is having difficulty with their homework, talk to their teacher. The teacher may not have much experience of teaching autistic children and may appreciate being given some information and resources about autism in education and how it particularly affects your child.

Ask about the topics that the group is studying and make sure the teacher is planning homework that suits your child. If you feel the homework is too easy or too hard, then discuss it with their teacher.

If the teacher will not adapt the homework, then discuss this with the SENCO, additional support for learning staff member or the most appropriate member of teaching or support staff. The school has a duty under the Equality Act 2010 in England, Wales and Scotland and the Disability Discrimination Act 1995 in Northern Ireland to make reasonable adjustments for any pupil with a disability.

If your child has an education health and care plan (EHCP), a statement of special educational needs (statement of SEN) or a coordinated support plan (CSP) and it doesn't include difficulties that your child has with homework, then you could ask for an early annual review to have it included.

If you feel that your child's educational needs are not being adequately met you may wish to contact our Education Rights Service for specific advice.

Support your child with motivation

Your child may have difficulty transferring working at school to home. Visual supports can really help autistic children to be more focused, so ask at school if they could have a visual timetable that extends to your child completing homework. A teacher could talk your child through this on days when homework is set.

A social story™ is another useful way to explain to a child about a school day and you can include a part about doing homework.

Try using a motivator, an item or activity that your child really likes, and include a picture/symbol of it on a visual timetable that your child can follow. For example, this could show 'homework first, then computer time' as this may encourage them to start homework.

Try to alternate the motivator, for example one day it might be 'homework then computer' and the next day it could be 'homework then watching a favourite video'. It also helps to use positive words of encouragement when your child is working well, especially if your child is anxious about the homework. Reward and encourage small steps by using targeting and specific praise.

If it does become extremely difficult for your child to work at home, ask school if they have a homework club, or speak to the headteacher to ask if they would considering setting one up.

Check your child is given clear instructions

It will help your child if the teacher uses clear and direct language to give precise instructions for homework, stating specifically what your child needs to do and when it needs to be done by.

If your child struggles with language processing, then they may need more time to note down homework. Written instructions breaking the homework down further can also be helpful. Flow charts, mind maps, spider diagrams or bullet points are more helpful than verbal explanations.

If your child has problems recording their homework in a homework diary, ask the teacher and/or teaching assistant if they can help them or adapt the way it's done. For example, if homework is written up on a white board for children to copy, could your child be supervised while doing this or could they have a printout of the homework?

Ask the teacher if they could simplify the way they present homework, by highlighting the important words on a homework sheet, using visual supports or bullet points. If the child has problems writing, could they use a computer to do their homework?

You could ask if your child can use a dictaphone, either to record the teacher's instructions about homework, or their own notes-to-self about the homework tasks, and listen to them at home.

Think about when and where to do homework

The best time to start homework will depend on your child. You may want to give them some time for a break after the school day, rather than going straight into starting homework. Or you could try starting straight after school.

You may wish to start homework before a preferred or fun activity, using a visual timetable to show your child what will be happening. It can help to do homework at the same time each day so it becomes part of a routine.

If possible, keep an area of your home free for your child to use to do their homework. It might help to set up a desk or table that they can work at. Ideally, it should be away from any distractions like the television. It helps if you ask other siblings not to interrupt them while they are working. Let your child know you are available if they need your help.

Help them with organisation and timing

If your child finds it difficult to concentrate on work for a long time, you may need to sit with them first to help keep them focused. You could start by getting them to work for just a short time and then build up gradually. It could help to use a timer to show how long they need to spend on the homework.

Communicate with your child's school

Keep the school up-to-date with how your child is progressing with homework. Ask the school if they can set up a home-school communication book or diary, so can you can keep in touch with them or keep in contact by talking to the class teacher, SENCO/additional support for learning staff member, headteacher or other appropriate member of staff about any homework issues you have.

There may be times when your child has more difficulties than usual and finds it particularly hard to concentrate, or behaves in a way that affects their ability to do homework. This might happen when there are significant changes in the family, or when your child is ill or anxious.

If doing homework causes extreme problems during this time, then see if it's possible for your child not to have homework for a while. You can always go back to trying to get your child to engage in it again by re-introducing it gradually.

Getting further help

You may find that you need to secure extra help for your child in school.

Our Education Rights Helpline provides impartial, confidential information, advice and support on education rights and entitlements for parents and carers of pre-school and school-age autistic children to help them get the educational support their child needs.

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Homework - a guide for parents and carers

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Learn about some of the possible reasons why your child might struggle with their homework and some strategies you can use to help your child finish their homework.

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In many cases, children are aware when they are doing things out of the ordinary or that other kids their age are not doing. They may be afraid of telling... Read more »

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Resources on ADHD and attention problems in children and how to help kids with ADHD thrive, at school and at home, at different ages.

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Post-traumatic stress disorder, or PTSD, is a mental health disorder that may develop after exposure to exceptionally threatening, frightening events or traumas. What is a trauma? Traumas are events that involve actual or threatened death, serious injury or sexual violence. For example, being assaulted, witnessing domestic violence, or being involved in a natural disaster such as a fire. Young people can experience a trauma because it happens to them, they see it happen to others, or they hear about it. How common is it to experience a trauma before adulthood? Exposure to traumatic events is very common among young people. By the end of adolescence, around 75% of young people will have been exposed to a traumatic event. How do children and young people react to traumatic events? Immediately after a traumatic event all children are likely to be distressed, tearful, frightened and in shock. Most young people will recover well with family support. The range of emotional reactions that young people can develop is very broad, but commonly includes: Upsetting memories of the traumatic event – These are usually vivid images. Sometimes young people hear, feel or smell things that happened during the event. The upsetting memories are difficult to control and seem to pop into the mind at any time. They often have a ‘here and now’ quality and it can almost feel as if the event is happening again such as a car crash, the smell of fire or being trapped in a building or the plight of refugees and asylum seekers. When this feeling is very strong, young people often say they have flashbacks. Changes in thinking and attitudes – Survivors have learned that life is fragile. They may see the world as a dangerous place. Guilt and self-blame is common. Changes in their body after trauma – Children may feel jumpy and startle easily. Reminders of the trauma can trigger panicky feelings. Sleep is often a problem. Mood changes – They might become more sad, withdrawn and tearful. Irritability is a very common reaction, with children becoming snappy or angry with those around them. Avoidance of upsetting memories – For example they try to get rid of the images in their mind. This takes up enormous amounts of mental energy. Children may avoid reminders of the trauma. This can mean that children’s lives become restricted. Young people often avoid talking about the event. Parents often don’t know the extent of children’s suffering because children do not tell them. Friends may not ask in case they upset the child further. Development of PTSD? Most young people will experience at least some of these reactions after exposure to a traumatic event. The majority will get better without any intervention. But if the reactions persist (lasting for more than a month) and affect day-to-day life, then young people may have developed a diagnosable PTSD. About one in seven young people develop persistent PTSD. How does PTSD present in very young children? Younger children might repeatedly play out the trauma in their games, or they may frequently draw aspects of it. Rather than having nightmares about the trauma, young children may have dreams of monsters instead. They may become very clingy, developing a fear of the dark, not wanting to sleep alone. Preschool children are more difficult to soothe after a trauma; they may be more irritable, distractible, and oppositional. What are the risk factors for PTSD? Any young person can develop PTSD after exposure to trauma. It is not a sign of weakness to develop PTSD. There are some factors which make it more or less likely that a young person will develop PTSD. Factors that can make things worse include: severity of exposure, thinking that you or those around you will die, belief that you cannot cope, or the world is dangerous, avoiding thinking or talking about the trauma. Factors that can help include family support. What should parents/carers and other adults look out for after a young person has experienced a trauma? It is hard for parents to know whether children are experiencing intrusive recollections unless children tell their parents. But they may be able to observe changes in sleep patterns and problems with moodiness and irritability. Unless children are asked directly about specific effects of trauma, PTSD is likely to be missed by adults. It is important to be sensitive to children’s upset, and give them time to express themselves. It is equally important that adults ask children directly about how they’ve been affected, otherwise it is very difficult to provide help for them. Adults should never force children to talk, but they can say that they are available to listen and help, if and when the child would like to talk. When should parents/carers seek professional help for PTSD? For young people who show mild stress reactions in the first four weeks after a trauma, watchful waiting is recommended. Many young people will recover in the first month without any professional help. If young people have severe symptoms in the first month, or if symptoms persist for longer than a month, help should be sought via the family GP. What treatments are available for PTSD? Trauma-focused CBT (Cognitive Behaviour Therapy) – This is a psychological treatment that is very effective in treating PTSD. Research shows that around 80% of young people with PTSD will fully recover after a short 12-session course of T-FCBT. Eye Movement Desensitization and Reprocessing (EMDR) is also available in some Child and Adolescent Mental Health Services (CAMHS). There is very little research yet to test whether EMDR is helpful for children and young people with PTSD, although it appears promising. No drug treatments are currently recommended in the UK for PTSD. Eleanor Leigh, Patrick Smith, Andrea Danese South London and Maudsley NHS Foundation Trust

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7 Things to Tell the Teacher About Your Child - Child Mind Institute

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Sharing key information can help educators make a connection. Here are seven categories of information you should be sure to tell the teacher.

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Ever since it was first diagnosed in the 1960s, ADHD (attention-deficit hyperactivity disorder) has been a controversial topic. Even experts often debate over how the disorder should be defined and what causes it.

While we don't completely understand what causes ADHD symptoms - difficulty regulating attention and emotions, hyperactivity, impulsivity - we do know that it's a neurodevelopmental disorder. That means that the brains of kids with ADHD develop differently from those of other kids. Researchers have started to identify the structural and chemical differences in the brain that may cause the symptoms associated with ADHD.

Many of the characteristics of ADHD are related to executive functioning. This refers to a set of mental skills that include working memory, emotional control, and complex problem-solving. Essentially, executive functions are the skills we all use to manage day-to-day tasks, such as time management, staying organized, and planning. While there are several different parts of the brain that contribute to executive functioning, the prefrontal cortex is especially important in regulating these skills.

Research has shown that in children with ADHD, the prefrontal cortex matures more slowly than typically developing kids. It is also slightly smaller in size. Similarly, the cerebellum, hippocampus, and amygdala are also thought to be smaller in volume in kids with ADHD.

Like every part of the brain, the cerebellum is involved in many different functions, but its role in the regulation of movement may be especially relevant to ADHD symptoms. A smaller cerebellum could contribute to difficulty with what's called "motor response inhibition," which refers to the ability to suppress actions that interfere with a current task, such as staying seated during a class lesson. Smaller hippocampus and amygdala sizes can cause impairment in the regulation of memory, emotion, and behavior, which is a common symptom of kids with ADHD.

While these regions of the brain may remain smaller in people with ADHD, studies have shown that they do continue to grow and mature as children get older. By adulthood, the difference in size when compared to individuals without the disorder has appeared to be less significant.

Another way to measure functionality in the brain is through activity and connectivity. Scientists use functional magnetic resonance imaging (fMRI) to measure changes in brain activity through blood flow. When an area of the brain is active, the level of blood flow to that region increases. In people with ADHD, studies using fMRI technology have shown irregular activity in several regions of the brain involved in motor, cognitive, and emotional regulation.

There is a collective network of structures in the brain that is unusually active in children with ADHD. This is called the default mode network (DMN), and it was first discovered by accident when researchers noticed high levels of brain activity while their study participants were simply resting.

The DMN is a relatively new concept and there is still some debate over which parts of the brain may be involved. It is thought to be the most active when we let our minds wander. In neurotypical children, this network shows lower levels of activity while they're engaged in a task that requires paying attention, and higher levels of activity when they're awake but simply daydreaming or recalling a memory. In children with ADHD, the network still shows a high amount of activity during active tasks that require focused attention. This difference may explain why kids with ADHD struggle to focus or concentrate in the classroom.

The unusual DMN activity seen in people with ADHD may also be explained by what's called its "functional connectivity" to other networks in the brain. The concept of functional connectivity refers to the idea that certain areas in the brain are connected if their functional behaviors are frequently correlated with each other. This could be a positive or negative correlation. For instance, there is another network in the brain called the "task-performing network" that allows us to perform attention-demanding tasks. In terms of functional connectivity, the DMN normally has a negative correlation to this network. This means that the DMN is less active while the task-performing network is more active. In children with ADHD, the DMN is thought to have a reduced negative correlation with this network due to weakened connectivity. This means that it's more active than it's supposed to be, which can lead to lapses in attention during goal-oriented tasks. Therefore, the minds of children with ADHD may wander during a task that demands attention, like homework.

Studies have also discovered that in people with ADHD, there is an unusually high level of functional connectivity between the brain regions that form part of a mechanism called the "selective visual attention system." This system allows us to determine what's important to notice or pay attention to in the moment. Irregular connectivity within this system may cause children with ADHD to notice irrelevant things in their field of vision, making it hard to know what to focus on.

In addition to differences in structure and connectivity, chemical imbalances in the brain may also play a role in causing ADHD symptoms.

Serving as our control center, the brain needs to both send and receive electrical signals or "messages" throughout the body. The brain is able to do this via nerve cells (neurons). However, there are gaps between neurons. Neurotransmitters are the chemical messengers that fill the gap and allow for messages to be passed along.

One very important neurotransmitter is dopamine, which has several functions. There are pathways in the brain that allow the transport of dopamine from one region to another to relay important information. There are four major dopamine pathways, and two of them are thought to contribute to the impairment of cognitive functioning we often see in kids with ADHD.

The first pathway is called the "dopamine reward pathway." When we experience something that's pleasurable such as eating tasty food, an increased amount of dopamine is released along this pathway and activates feelings of pleasure and euphoria. It is theorized that these feelings of pleasure are reinforced by the connection between a part of the brain that processes pleasure and the hippocampus, which plays an important role in memory. That is, we remember what food is associated with this feeling of pleasure and it motivates us to eat it again.

The second pathway, known as the "mesocortical pathway," connects an area of the brain that's rich in dopamine to the prefrontal cortex. Via the transmission of dopamine, this pathway helps the prefrontal cortex facilitate executive functions such as cognition, working memory, and decision-making.

In children with ADHD, these two pathways are thought to be disrupted, which can lead to impairment of cognitive and motivational functioning. Scientists believe that these disruptions could be due to an unusual number of dopamine transporters in the brains of people with ADHD. A dopamine transporter is a protein that is responsible for removing dopamine from the gap between neurons and terminating dopamine transmission. An increased number of these transporters can lead to unusually low amounts of dopamine in the brain. One piece of evidence for this theory is that stimulant medications such as Adderall are often successful in reducing ADHD symptoms, and these medications suppress the reuptake, or removal, of dopamine.

While we may not know the exact causes of ADHD symptoms, advances in research have given us a better understanding of the disorder. Identifying the structural and chemical differences in the brains of children with ADHD will not only validate their struggles but may also lead to significant improvements in treatment.

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How Is the ADHD Brain Different? - Child Mind Institute

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An in-depth look at the underlying causes of ADHD symptoms in children.

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Exceptional Children - Orange County School District

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Family Support Network of North Carolina

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Family Support Network of North Carolina

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Available Services | Family Support Network of North Carolina

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IEP (Individualized Education Plan) - Orange County School District

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Look here to find:

Autism social and support groups

Culturally competent groups

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Finding your community is known to contribute to an increase in happiness, improved health and a better quality of life. Check out this list of online peer groups, parent support groups, recreation activities, religious groups, among others, and learn how to start your own autism support group or inclusive activity.

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Find providers and resources that meet your family's needs. Find providers, therapies and interventions, schools, evaluations, support, services, and more

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Autism Speaks does not provide medical or legal advice or services. Rather, Autism Speaks provides general information about autism as a service to the community. The information provided on our website is not a recommendation, referral or endorsement of any resource, therapeutic method, or service provider and does not replace the advice of medical, legal or educational professionals. Autism Speaks has not validated and is not responsible for any information, events, or services provided by third parties. The views and opinions expressed in blogs on our website do not necessarily reflect the views of Autism Speaks.

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How to Find an Autism Provider who Understands your Culture

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How to Find an Autism Provider who Understands your Culture

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Advice from Autism Speaks on how to find a provider who understand your culture.

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How to find an autism provider who understands your culture | Autism Speaks

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Our cultural identity—shaped by race, ethnicity, religion, values and traditions—deeply influences how we navigate the world, including how we approach care. That’s why culturally competent care matters.

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Sudden and Severe Onset OCD (PANS/PANDAS) – Practical Advice for Practitioners and Parents

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Sudden and Severe Onset OCD (PANS/PANDAS) – Practical Advice for Practitioners and Parents

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Sudden and Severe Onset OCD (PANS/PANDAS) – Practical Advice for Practitioners and Parents

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Sudden and Severe Onset OCD (PANS PANDAS) – Practical Advice for Practitioners and ParentsCompiled by Michael Jenike, MD and Susan Dailey, mom and advocate Many thanks to the contributing clinicians and researchers, who answered our questions with great patience, and

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Learn about PANS and PANDAS

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PANS (Paediatric Acute-onset Neuropsychiatric Syndrome)
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PANS is a neuropsychiatric condition which is triggered by a misdirected immune response to a variety of triggers, resulting in a constellation of symptoms as outlined below.

​PANS is a clinical diagnosis and there is no specific test which will prove or disprove the condition. In order for a diagnosis to be made, presentation of the following symptoms must occur:

PANS Diagnostic Criteria
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An abrupt, acute, dramatic onset* (usually within 24-48 hours) of obsessive compulsive disorder (OCD)** or severely restricted food intake*** along with two or more of the following symptoms which are not better explained by a known neurologic or medical disorder.

​Anxiety (heightened anxiety, separation anxiety, irrational fears, panic episodes)

Tics

Emotional lability and/or Depression

Irritability, Aggression, and/or Severely Oppositional Behaviours

Behavioural (Developmental) Regression (increase in temper tantrums, loss of age-appropriate language, clingy behaviour not related to anxiety).

Sudden Deterioration in School Performance (due to difficulties with memory, concentration, hyperactivity, impulsivity, new deficits of visuospatial skills)

Motor or Sensory Abnormalities (dysgraphia, clumsiness, tics, new sensory sensitivities to light, noise, smell, taste or texture).

Insomnia and/or Sleep disturbances

Enuresis and/or Urinary frequency

​Whilst not part of the diagnostic criteria, in approximately 25% of cases there have been reports of Psychosis and/or Hallucinations

​PANDAS (Paediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections)
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PANDAS is a subset of PANS. Similarly, it is a neuropsychiatric condition which is triggered by a misdirected immune response to a Streptococcal infection which results in a variety of symptoms as outlined below.

PANDAS Diagnostic Criteria
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Usually starting with an acute onset of obsessive compulsive disorder and/or tics, particularly multiple, complex or unusual tics. PANDAS symptoms can then appear to wax and wane with the child experiencing flares periodically, following illness or periods of stress. The child is usually between the ages of 3 and puberty when first symptoms occur and usually appear following a streptococcal infection such as Sinusitus, Ear infections or Scarlet Fever. In some cases children can carry the streptococcus bacteria without showing signs of illness.

Whilst it is not a diagnostic requirement, in addition to OCD** and/or tics, children may also experience co-morbid symptoms similar to those seen in PANS.​
* We would like to note that the requirement within the diagnostic criteria for an abrupt or acute onset was originally stipulated in order to create a well-defined cohort of patients for research purposes. It is beginning to be acknowledged that onset may not always be as rapid as the diagnostic criteria currently state, however they have yet to be updated to reflect this. ** OCD may include any of the following:

Contamination obsessions and compulsions

Obsessions that harm will come to others and/or related compulsions

Sexual or religious obsessions

Repeating compulsions

Symmetry and exactness obsessions

Ordering/arranging compulsions

Counting compulsions

Checking obsessions or compulsions

Excessive reassurance seeking

Need to touch, tap or rub

Intrusive images, words, music or nonsense sounds

Ritualised eating behaviours​

*** Severely restricted food intake may be related to contamination fears, obsessional fears of choking, or other obsessional fears including a new obsession with body image or weight.

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What are PANS and PANDAS? - PANS PANDAS UK

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Welcome to PANS PANDAS UK. This is our What are PANS and PANDAS? page.

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Mental Health for Migrant & Refugee Communities

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Mental Health for Migrant & Refugee Communities

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Mental Health for Migrant & Refugee Communities | NNIRR

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Resources for Migrant Communities On this page we offer a list of migrant mental health resources, organizations that provide services to migrant families,…

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Help Your Child Manage Anxiety: Tips for Home & School

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Help Your Child Manage Anxiety: Tips for Home & School

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Anxiety is another word for feeling worried or scared. It's normal for children and teens to feel anxious sometimes, like before a big test at school or talking in front of a group of people. But if your child's anxiety gets in the way of normal activities, such as sleeping alone at night, playing outside or going to school, they may need extra support.

The good news is that there are things you can do to help prevent your child from feeling anxious and help them handle worries when they happen. Talk with your pediatrician to discuss strategies and tips that can help.

What are some common signs of anxiety in children?

If your child is feeling anxious, they may not be able to tell you. Your child may feel bad or sick without knowing why, or you may notice they seem restless or tired.

Feeling as if their heart is racing

Sweating or blushing

Shaking or feeling sick to their stomach

Feeling very cold or hot

Trouble paying attention or sitting still

Touching the crotch area (for young boys)

How can I help my child manage anxiety at home?

These tips are helpful for all children, but they can be especially helpful for children with anxiety. Parenting is a busy job, so use your judgment about which tips make the most sense for your family.

Connect with your child

Set aside one-on-one time every day without TV or other media. Even just 10 minutes each day can make a big difference. Try gardening or taking care of houseplants, drawing or going for a bike ride.

Praise your child and make them feel good about themselves. For example, "You did a great job on that homework assignment!" or "Thank you for helping me with the laundry. I'm so lucky to have your help."

Find out what's worrying your child, because stress can make them feel anxious. Things such as being bullied at school, divorce, or a death in the family can make a child feel anxious. Your child may need extra help to handle issues such as these.

Help your child learn to manage fears

When your child is calm, start a conversation about things they can do to manage fears and worries when they happen. For example, let them know that they can

Practice deep breathing and muscle relaxation.

Use positive self-talk (for example, "I can try this" instead of "I can't do this").

Think of a safe place, such as their bedroom or favorite place outdoors.

Build healthy habits

Healthy lifestyle habits can help reduce stress and support a positive mood.

Get active! Encourage your child to be active for at least an hour every day. This activity can include playing outside, joining a sports team or an activity at the YMCA, biking or walking to school, or dancing at home to favorite music.

Eat healthy. Eat healthy meals every day, including fruits and vegetables, whole grains, and protein foods. Remember to eat breakfast!

Get plenty of sleep. School-aged children need 9 to 12 hours of sleep every night, and teens need 8 to 10 hours.

Build a family media plan to set healthy guidelines around entertainment screen time. Avoid scary or violent TV shows, video games, and movies.

Set up family routines. Follow a regular schedule for playtime, mealtime, and bedtime. Knowing what to expect can help your child feel safe and secure.

How can I help my child manage school anxiety?

Children may find it hard to focus on or even go to school when they're feeling worried. If your child is having trouble in school, try these ways to help.

Gently but firmly tell your child why it's important to go to school.

Talk with your child's teachers and the guidance counselor about what to do if your child asks to go home from school early.

If you think your child may be upset by family stress or pressure to do well in school, let them know they are doing a good job and you're proud of them.

Help your child set realistic goals for school. If they set goals that are too hard to meet, they may feel worse about themselves.

Remind your child that they can take steps to control their worries. For example, they can think about what to do ahead of time to handle a stressful situation.

Reward your child's brave behaviors at school. Spending time doing fun activities with a parent is a very powerful reward.

Remember, you know your child best.

Whether it's at school or the doctor's office, you are your child's biggest advocate. Don't hesitate to speak up on behalf of your child.

When do I need to go back to the doctor?

If your child's anxiety doesn't go away or gets worse, get back in touch with the doctor. You and the doctor can make a plan to try new approaches or strategies with your child.

It's especially important to talk with your child's doctor if:

Your child starts to experience other behavior problems, such as shyness.

Something scary happens in your child's life that may make their anxiety worse, such as an injury or death in the family.

You suspect your child's anxiety is affecting another medical condition (for example, if your child's asthma gets worse with anxiety).

The doctor can also help you decide whether visiting a specialist may help. For example, a type of therapy called cognitive behavioral therapy can be helpful for children with anxiety.

Make time to care for yourself, too.

Parenting can be stressful. If you're feeling overwhelmed, don't be afraid to ask for support from family, close friends, social services, or your faith community. Children pick up on the stress and worries of adults, so getting support for yourself can help your child too.

More information

Adapted from Addressing Mental Health Concerns in Pediatrics: A Practical Resource Toolkit for Clinicians, 2nd edition (Copyright © 2021 American Academy of Pediatrics)

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anxiety; fear; childhood fears; stress; mental health; media; positive parenting; school; self-care

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Help Your Child Manage Anxiety: Tips for Home & School

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​Anxiety is another word for feeling worried or scared. It's normal for children at any age to feel anxious sometimes, such as if they need to take a big test at school or talk in front of a group of people.

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Local Spanish-Speaking Mental Health Providers

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Local Spanish-Speaking Mental Health Providers

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NC Spanish-Speaking Mental Health Provider List | El Futuro

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The need for Spanish language mental health providers in North Carolina is high. This list has been created to help Spanish-speaking mental health clients and providers connect to one another.

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Mental Health: Taking Care of Yourself & Loved Ones

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Mental Health: Taking Care of Yourself & Loved Ones

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Have you noticed that you are feeling sad, or find it hard to stay hopeful about the future? Many in the immigrant community are feeling anxious about deportations and raids because of the current political climate and changes. This is a normal reaction to stressful policy developments and difficult personal situations. However, if these feelings persist for more than two weeks, and strengthen to the point where they affect your ability to go to work, school, or to have positive interactions with other people, you may be experiencing clinical depression.

Depression (major depressive disorder) is a common and serious medical illness that negatively affects how you feel, the way you think and how you act. Fortunately, it is also treatable. It affects one in fifteen adults (6.7%) in a given year, so if you are experiencing any of these feelings you are not alone.
Symptoms can vary from mild to severe and can include:

Feeling sad or having a depressed mood

Loss of interest or pleasure in activities once enjoyed

Changes in appetite - weight loss or gain unrelated to dieting

Trouble sleeping or sleeping too much

Loss of energy or increased fatigue

Increase in purposeless physical activity (e.g., hand-wringing or pacing) or slowed movements and speech (actions observable by others)

Feeling worthless or guilty

Difficulty thinking, concentrating or making decisions

Thoughts of death or suicide

If you or someone you know is experiencing any of the above, make an appointment with a health practitioner. They can help evaluate your symptoms, and provide treatment.

Have you ever felt nervous? Maybe before going in for a job interview, or before speaking in public? These are normal situations in which to feel nervous, or "anxious." However, these "normal feelings and experiences" are different from suffering from an anxiety-related disorder. In an anxiety-related disorder, the fear or worry does not go away and can get worse over time. It can influence someone's life to the extent that it can interfere with daily activities like school, work and/or relationships.

If you or someone you know is experiencing any of the above, make an appointment with a health practitioner. They can help evaluate your symptoms, and provide treatment.

Have you noticed that your friends or family members are feeling sad, or find it hard to stay hopeful about the future? Many in the immigrant community are feeling anxious about deportations and raids because of the current political climate and changes.
Find more resources and materials on depression & anxiety here.

Many mixed status families may be questioning how safe it is for them to seek health services given increased immigration enforcement. You should know that there are strong privacy rules in place to protect patients, regardless of immigration status, at hospitals and health clinics.

Here are a few additional details to keep in mind:

The Affordable Care Act is still the law, and you should apply for health insurance if you or your children are eligible

Strong privacy rules protect families applying for health insurance, including families whose members have different immigration statuses

Do not provide your immigration status if you are not applying for insurance yourself

Everyone has a right to an interpreter when applying for health insurance or seeking health care, at no cost

If you are uninsured, you have certain health care options, regardless of your immigration status, including emergency room care, public health services like immunizations and HIV screening, and community health centers and free clinics.

Health care providers should not ask for immigration status information

Existing policy keeps immigration officials away from hospitals and medical facilities

You should not have to show a photo ID to receive medical treatment

For more detailed information on the rights of patients to privacy and services, please read NILC's resource.

Though it may feel taboo to talk about your struggles or concerns with friends and family, sharing your worries with someone close to you who is supportive can actually ease some of your anxiety by making you feel less alone, and giving you space to say out loud what is worrying you, and how. A confidant can also help you connect with professionals who can provide additional support through conversations, breathing exercises, and treatment.

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Mental Health: Taking Care of Yourself and Loved Ones - Informed Immigrant

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Find resources for managing your mental health and for your immigrant family, and friends. You and your loved ones deserve to feel validated, supported, and loved.

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A Therapist Like Me is a non-profit, 501(c)3 in North Carolina dedicated to connecting uniquely diverse clients from historically marginalized communities to uniquely diverse therapists from historically marginalized communities, advancing therapists of color, providing financial gifts to uniquely diverse clients from historically marginalized communities for psychotherapy, reducing societal stigma surrounding mental health, and supporting our community.

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Search the most complete database. Find .

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5 Minute Easy and Relaxing Yoga for Anxiety

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Parent’s Guide to Teen Depression - HelpGuide.org

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Learn what teen depression looks like in teens and what you can do to help your child.

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Understanding Depression: What Teens and Young Adults Should Know

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From a hedgehog too anxious to go ice skating to a puppy who can't make his letters come out right, children's books address many emotional, behavioral and learning challenges kids face. These books help kids name and understand feelings and experiences they may be struggling with. At the Child Mind Institute we've contacted publishers all over to call in popular children's books about mental health and learning disorders and other common challenges, like dealing with painful experiences and coping with strong emotions. We included books for kids up to 12, from picture books to be read with preschoolers to chapter books for independent reading by older children. Our clinicians read them all and picked the best in each category, based on how helpful they found them. Here you will see descriptions of 77 books we like, and we hope you will find useful.

Popular children's books about abuse and establishing boundaries.

Written by Zach and Kimberly King, illustrated by Sue Rama
Popular children's books about ADHD with emphasis on why it shouldn't define them.

Written by Jeanne Kraus, illustrated by Whitney Martin
Cory tells readers about himself in this picture book with black-and-white illustrations. Cory says that sometimes kids make fun of him and he isn't sure why. "Sometimes my whole body falls off the chair!" But readers also learn that Cory has persevered, concentrating in karate class, making friends at bowling club, and helping other kids with math. The important parting message: "Nobody needs to be good at everything. But I found out that I am good at a lot of things." Ages 6-11. Published by Magination Press.

Written by Mari Schuh, illustrated by Isabel
In a warm and friendly way, Annabelle, a real girl from Long Island, New York, explains how ADHD affects her. She talks about symptoms, medication, and helpful strategies. She reassures readers that "ADHD doesn't stop me from doing most things." For instance, Annabelle is a Girl Scout and loves to swim and run. "The book has good visuals too," adds an expert from the Child Mind Institute. A Spanish language version is also available. Ages 6-9. Published by Amicus.

Popular children's books on anxiety and how they can take charge of their fears.

Written by Alex Boniello and April Lavalle, illustrated by James Kwan
A story of a kid robot who sometimes gets "the zaps" provides a clever way to introduce the concept of anxiety to kids, as well as ways to manage it. "This playful story is perfect for families looking to start open conversations about anxiety with their children while also normalizing the sensation of other emotions that come along with it," says an expert from the Child Mind Institute. Ages 4-8. Published by Harry N. Abrams.

Written by Imogen Harrison
Through mazes, craft projects, and dozens of other fun exercises, kids learn how to let go of worries and remain calm. "The book will help children develop emotional awareness and recognize their feelings and how they experience them," says an expert from the Child Mind Institute. "From here, a wide range of practical coping strategies can be tried out, practiced, and mastered." The Calming Sparkle Jar project is especially fun. Ages 8-12. Published by Sky Pony Press.

Written by Elly Swartz
Autumn has been struggling since her best friend moved away and her dad went to Ecuador with the Peace Corps. Trying not to let her social anxiety stop her from doing something new, she applies to be the secret voice of the school newspaper's advice column - and she gets the job! When her friends write in for advice, Autumn is pushed outside her comfort zone. The book provides good examples of social anxiety-related thoughts, feeling embarrassed, words-getting-stuck syndrome, and a good theme of being brave," says an expert from the Child Mind Institute. Ages 10-14. Published by Delacorte Press.

Written and illustrated by Andi Green
In this whimsical rhyming book, Wince, the monster of worries, learns that the more he worries, the more the pesky WorryBug grows. Eventually the WorryBug grows so big that it can't be ignored, and Wince knows he needs to do something. The book does a good job of illustrating how anxiety can become overwhelming and teaches kids how they can take charge of their anxiety. Ages 3-8. Published by Monsters in My Head.

Written by Danielle Marie Price, illustrated by Nana Gonzales
One day, Ellie was feeling too grumpy to eat pancakes. Her mom says, "That happens sometimes" and gets a yoga mat out of the closet. Ellie and her mom do various yoga poses and breathing exercises. Then it's pancake time! "A good introduction to mindfulness and yoga, this book highlights how trying something new can improve feelings," says an expert from the Child Mind Institute. Ages 4-8. Published by Warren Publishing

Written by Nicole C. Kear, illustrated by Tracy Dockray
Seven-year-old Veronica wants to help her classmate Maya conquer her fear of bugs, which is preventing her from playing at recess. Veronica comes up with a step-by-step plan that starts with drawing a spider. "Showing gradual exposure to anxieties is a great approach," says an expert at the Child Mind Institute. Ages 7-10. Published by Imprint.

Written by Marcus Stroman with Samantha Thornhill
Stroman, a pitcher for the Chicago Cubs, drew on some of his childhood experiences to write this fast-paced novel. Marcus wants to be the greatest pitcher of all time, and his dad pushes him hard to achieve his goals. But Marcus doesn't believe in himself as much as his family does. Constant teasing about being short for his age begins to affect his game. Marcus's mom takes him to see a mental health coach. "Marcus shares how he copes with the aftermath of divorce, very different parenting styles, bullying, and pressure from his dad and himself to excel as a young baseball pitcher," says an expert from the Child Mind Institute. "Realistic and practical strategies to challenge and change negative thoughts and to practice mindfulness are woven into the narrative." The verdict: It will grip the reader from start to finish! Ages 8-14. Published by Aladdin.

In this helpful story to read before the first day of school, a cat detective gives her classmates smart advice about how to overcome their anxieties. For instance, when a fellow student tells Hattie that he's nervous about standing up in front of the class, she pulls a squishy ball out of her Worry Detective Tool Belt. Hattie uses her toolkit to playfully demonstrate useful strategies like "movement activities, tensing and releasing muscles, coping self-talk, and mindful breathing," says an expert from the Child Mind Institute. Ages 4-8. Published by Viking Books for Young Readers.

Written and illustrated by Jo Rooks
A cute hedgehog turns down ice-skating and playing in the snow with his animal friends because of his worries. "What if he had forgotten how to skate? He could fall and hurt himself." When Hector receives a fun invitation to the Winter Forest Party, he hesitates for a while, and then realizes that he has to be brave. "It's an adorable story," says an expert at the Child Mind Institute. "I like that Hector does a little more, and then a little more, and so on." Ages 4-8. Published by Magination Press.

By Jayneen Sanders, illustrated by Stephanie Fizer Coleman
Anxious about school, soccer practice, and monsters under his bed, baby bear worried day and night, despite his family telling him to stop worrying. But when his mom began encouraging him to talk about and even draw out his worries, the feelings began to subside. "I like that the book emphasizes the importance of sharing your thoughts and feelings," says an expert at the Child Mind Institute. Another plus: The book suggests questions that you can ask your child as you're reading together. Ages 6-10. Published by Educate2Empower Publishing.

Written by Victoria M. Sanchez, illustrated by Jess Golden
In this new picture book, Pilar lives and breathes ballet - she even does pliés while brushing her teeth. But auditioning for the winter ballet performance makes her feel scared, and she almost doesn't go. By using smart coping techniques, like positive thinking and talking with her friends, she's able to overcome her fears. Bravo! Ages 4-8. Published by Albert Whitman & Company.

Written and illustrated by Tom Percival
This brilliantly illustrated story stands out for helping kids visualize anxiety and see how it grows. While playing at the park, Ruby discovers a worry - it's depicted as a yellow blob with googly eyes that starts out small but gets bigger and bigger. Eventually, it stops her from doing the things she loves and she can't stop thinking about it. But when she sees a boy sitting on a park bench next to a worry of his own, she starts to talk to him. Then both of their worries begin to fade. "Kids can easily identify with the images and simple storyline," says an expert from the Child Mind Institute. Another notes that the story helps kids realize that everyone worries sometimes and encourages them to talk about their feelings. Ages 4-8. Published by Bloomsbury Children's Books.

Written by Alberto Soler and Concepción Roger, illustrated by Nuria Albes a

Published exclusively in Spanish, this book focuses on a girl who begins to feel anxious. "It contains a great metaphor for anxiety - a knot in the stomach - and provides ways to talk back to the anxiety bully in all of us," says an expert at the Child Mind Institute. Ages 4-8. Published by B De Blok.
Written by Dawn Huebner, illustrated by Bonnie Matthews

Popular children's books about autism and related disorders.
Written by Nancy Carlson and Armond Isaak, illustrated by Nancy Carlson

Co-written by a boy with Asperger's, this picture book "gives a simple understanding of why children with Asperger's struggle to attend parties, and talks about the importance of learning flexibility," says an expert at the Child Mind Institute. (For more about the term Asperger's and its relationship to autism, see our guide to autism terminology.) Readers may relate to Armond's fear of balloons popping and not being able to think of anything to say. In the end, Armond admits to his mom that the party was hard, but he's glad he went. Ages 4-8. Published by Free Spirit Publishing.
Written by Alison Green Myers

For Axel, who has autism, the sudden changes that a tornado brings are extra hard to handle. The storm damages Axel's house and his beloved eagle's nest. His dad comes back home to help with the damage. "The book provides a great depiction of complicated and changing family dynamics," says an expert from the Child Mind Institute. "It features multiple autistic characters and discusses needs related to sensory and information processing." Readers who are especially interested in birds, animals, or nature will enjoy this story. Ages 9-12. Published by Dutton Children's Books.
Written by Elana K. Arnold, illustrated by Charles Santoso

On the surface, it's a sweet boy-wants-pet story. Bixby's (aka Bat's) mom is a veterinarian, and she brings home a baby skunk that he desperately wants to keep. But readers with autism may relate to chatter about itchy and uncomfortable clothes, sticking with routines, and only having friends who are grown-ups. "It does a wonderful job of describing the day-to-day experience of high-functioning children with ASD," says an expert at the Child Mind Institute. Ages 6-10. Published by Walden Pond Press.
Written by Meg Eden Kuyatt

Inspired by the author's own childhood experiences on the autism spectrum, this novel in verse (poetry) explores what it's like for a 12-year-old who has to keep her feelings locked inside. She usually follows the rules for "being normal," until one day she can't hold it together anymore. Although tough at first, it's the turning point that puts her on a path to celebrate her differences rather than hiding them. "I loved this book," says an expert from the Child Mind Institute. "It's a beautiful story about family relationships, support, and how to communicate with people you love but can't completely relate to. It emphasizes compassion and has a great discussion about the ways that social norms help and hurt." Ages 8-12. Published by Scholastic Press.

Henry, a boy on the autism spectrum, forgets to raise his hand in school and offends his classmate Daisy by using her Latin plant name, Leucanthemum vulgare. While his fellow students sometimes find him odd or annoying, a field trip to the local botanical garden allows Henry's knowledge to shine and his classmates are wowed. "This beautifully illustrated book normalizes the common challenges of neurodiverse children," says an expert from the Child Mind Institute. "It also highlights that a special interest can be a source of peer connection." Ages 4-8. Published by Orca Book Publishers.
Written by Phil Bildner, illustrated by Tim Probert

Popular children's books on body image, eating disorders, and the importance of body positivity.
Written by Nabela Noor, illustrated by Nabi H. Ali

Diversity advocate and mom Nabela Noor writes a moving story about a young Bangladeshi girl who wonders if there is something wrong with the way she looks. Her worries begin after she hears her mom, dad, and sister being critical of their own weight. At dinner, the girl tells her family that she wants to go on a diet, too. Surprised by her comment, the family discusses what beauty means. "The story has a wonderful message about looking internally for beauty, watching the things we say in front of others, and sharing kindness with the world," says an expert from the Child Mind Institute. Ages 4-8. Published by Simon & Schuster Books for Young Readers.
Written and illustrated by Maggie Edkins Willis

With realistic-sounding dialogue and brilliant illustrations, this graphic novel deftly conveys the impact of eating disorders on two sisters and their family. At first, the older sister is diagnosed with anorexia nervosa. Eventually the younger sister struggles with body image too. "The book presents digestible conversations about eating disorder development, treatment, and its relevance in middle and high school settings," says an expert from the Child Mind Institute. It also presents healthy strategies to avoid disordered eating, such as surrounding yourself with positive friends rather than those who criticize your body. Ages 10-14. Published by Roaring Brook Press.
Written by Lisa Fipps

In this critically acclaimed novel in verse (poetry), Ellie has been bullied about her weight since she was five years old. She made "Fat Girl Rules" that she follows, including not eating in public. With a strong support network - a friend, her father, and a therapist - will she be able to put the Fat Girl Rules behind her and show the world her fabulous self? "Highlighting the importance of body positivity, this book shows the impact that therapy can have on helping someone handle difficult emotions and developing skills to voice their needs and opinions to others," says an expert from the Child Mind Institute. Ages 10-14. Published by Nancy Paulsen Books.
Written by Alyson Gerber

In seventh grade, Sarah starts to feel slower on the basketball court. Her body is changing - and she doesn't like it one bit. She begins skipping meals and her discomfort with her body grows. "The book presents a nuanced take on disordered eating behaviors, including a mother's role in a child's eating and relationship with food," says an expert from the Child Mind Institute. Ages 8-12. Published by Scholastic Inc.
Written by Jen Petro-Roy

The author sprinkles her personal experiences with an eating disorder into this well-organized self-help book. "It offers guidance and practical tools for those struggling with disordered eating and negative body image," says an expert from the Child Mind Institute. The chapters on perfectionism, selfie culture, and clothing sizes are especially interesting. Action items include creating a self-soothing tool kit and creating a list of people you admire. Ages 9-14. Published by Feiwel & Friends.

Popular children's books that cover bullying and show ways to respond to it.
Written by Hope Gilchrist, illustrated by Zoe Jordon

Toby makes his friends laugh when he teases a classmate over his weird clothes. He's just trying to be funny and he isn't beating anyone up, so he can't be a bully - can he? This independently published paperback helps children recognize when teasing crosses the line into bullying. Ages 6-9. Published by CreateSpace Independent Publishing Platform.
Written and illustrated by Kevin Henkes

This sweet story prepares kids for how short-lived teasing can be. On the first day of school, Victoria picks on Chrysanthemum because she has the same name as a flower, and Chrysanthemum wilts under the ridicule. Then the students learn that a teacher has a similar name, and all of a sudden Chrysanthemum is cool. Ages 4-8. Published by Mulberry Books.
Written by Julia Cook, illustrated by Anita DuFalla

Particularly good for an anxious or literal child, this rhyming book helps distinguish between teasing and bullying. "There are two types of teasing: the nice and the mean," Cook writes. "You think that everyone's against you, but it's not like it seems." Readers will learn strategies for responding to both good-natured teasing and bullying. Ages 5-10. Published by Boys Town Press.
Written by Lisa Yee

In a fast-paced chapter book that will appeal to reluctant readers, Marley thinks seventh grade will be boring until he draws attention from the school bully. Digger pushes Marley down in the hallway, and the drama unfolds. "It's a very relatable story for kids who feel like outsiders," says an expert at the Child Mind Institute. Bonus: If your child is a fan of Star Wars, there are loads of references. Ages 8-12. Published by Arthur A. Levine Books.
Written by R.J. Palacio

Popular children's books about depression and handling complex emotions.

Kids and parents alike will find helpful messages in this story about a boy who feels too sad to get out of bed. The boy's parents and younger sibling try to cheer him up with jokes, silly faces, and toys. But, ultimately, it takes a lot of waiting and love. "Young children will find it helpful to see images of someone who is sad being supported and not rushed to come out of sadness," says an expert from the Child Mind Institute. "Plus, for parents, the story models how to validate and sit with discomfort instead of trying to fix the situation for their children." An author's note from Tomlinson, a psychologist, is directed to parents. Ages 4-8. Published by Kokila.
Written by Anna Lazowski, illustrated by Penny Neville-Lee

Sadness and other big emotions take the form of a dark cloud, a ball of worries, and a swirl of fog in this lyrical book about childhood depression. The cloud usually follows as Abigail goes about her activities, but sometimes she's able to leave it behind. At the beach, for instance, she traps it in a sandcastle and goes for ice cream. "The illustrations really help the story come to life and provide an easier way for young kids who may not have the vocabulary to describe their emotions," says an expert from the Child Mind Institute. "The images of the character embracing her cloud and finding enough distance from it to see light and joy are heartwarming and provide hope." Ages 4-8. Published by Kids Can Press.
Written by Diane Guerrero with Erica Moroz

An actress on TV shows such as Orange Is the New Black, Guerrero shares the heartbreaking story of her Colombian parents being deported when she was 14. She also reveals how she battled depression, and had suicidal thoughts in her early 20s. "I wanted so badly to prove that I could take care of myself. That I didn't need anyone. That I was grown-up," she writes. "By the time I admitted to myself that I did still need others, I had pushed away the people I loved." Ages 12+. Published by Henry Holt and Co.
Written and illustrated by Eva Eland

Portraying sadness as a visitor that you shouldn't be afraid of, this book makes it easier for kids to imagine the emotion as something outside themselves. When sadness arrives, the main character still reads, plays, and decides sadness doesn't want to stay indoors. "The idea of continuing to do things with sadness is important," says an expert from the Child Mind Institute. "It's something that's with the child, but doesn't define them." Ages 3-8. Published by Random House Books for Young Readers.

Popular children's books about dyslexia, self-esteem, and positive messages about hard work.
Aaron Slater, Illustrator

In this best-selling rhyming book, Aaron wants to be a storyteller, but he's having trouble putting a single word down on a piece of paper. Then he realizes his strength is his imagination. "The book shows that reading struggles are not rooted in lack of interest, motivation, or intelligence," says an expert from the Child Mind Institute. "You can feel the character's pain and joy as he finds a way to express himself." This book is printed in a dyslexia-friendly font. Ages 4-8. Published by Harry N. Abrams.
Written and illustrated by Claire Alexander

This sweet picture book follows Stan, a puppy, and his animal classmates. Stan's letters come out "back to front and upside down, and some didn't look like letters at all," but he's afraid to ask his teacher for help because he thinks the other kids will laugh at him. When he finally does, he learns that with help - and lots of practice - he can succeed. "The book sends the positive message that things will get better with a bit of hard work," says an expert at the Child Mind Institute. Ages 4-8. Published by Eerdmans Books for Young Readers.
Written by Gavin Newsom with Ruby Shamir, illustrated by Alexandra Thompson

Ben, a star baseball player, is frustrated that he's not learning to read as easily as his classmates, especially Emma, who carries around big books. But everything isn't as it seems. "A sweet and simple story that provides encouragement and normalization to struggling readers, with an emphasis on reinforcing effort, practice, and hard work," says an expert from the Child Mind Institute. One of the best parts: the letter at the end from California governor and the book's author, Gavin Newsom, who calls his dyslexia a gift. Ages 5-9. Published by Philomel Books.
Written by Lynda Mullaly Hunt

Popular children's books on feelings and managing complex emotions.

Especially useful for kids who have trouble verbalizing their emotions, this story demonstrates that feelings aren't always visible to others. During various stressful situations, ranging from playing goalie for the first time to starting at a new school, the book illustrates the wild swings of emotions a boy experiences. One minute there's a roller coaster screaming through his ribs, the next he's in a cave full of bats. "It also provides great examples of when those emotions may surface and models calming strategies," says an expert from the Child Mind Institute. Ages 4-8. Published by Free Spirit Publishing.
Written and illustrated by Barney Saltzberg

This short rhyming book with expressive cartoon-like illustrations will help validate the big feelings of toddlers and preschoolers. A young cat, who doesn't want to be cheered up, questions "Why do I have to be happy?" before insisting that he wants to be mad for a while and throwing himself on the floor. "The book includes great analogies, such as describing anger as 'feeling like a crocodile,'" says an expert from the Child Mind Institute. "I also appreciated that it's not about getting rid of the emotion, but managing it with strategies like alone time and talking to someone." Ages 3-5. Published by Orchard Books.
Written by Jo Witek, illustrated by Christine Roussey

In this sturdy book with beautiful heart-shaped cutouts, a girl explains that her heart is full of feelings. Each spread focuses on a different emotion, such as happiness, bravery, and fear. The descriptions of the feelings are particularly engaging: "Some days my heart feels as heavy as an elephant. There's a dark cloud over my head and tears fall like rain. This is when my heart is sad." Ages 3-6. Published by Harry N. Abrams.
Written by Dr. Seuss, illustrated by Steve Johnson and Lou Fancher

This little-known Dr. Seuss story gives young kids a groundwork for describing their feelings, normalizing the experience of having multiple emotions. Bonus: It will also help toddlers and preschoolers learn colors. Ages 3-5. Published by Knopf Books for Young Readers.
Written by Poppy O'Neill

Packed with 45 self-help activities that most kids as young as age eight or nine can complete on their own, this workbook could serve as a great addition to therapy or a stand-alone resource. Activities include breathing exercises, a gratitude journal, and a positivity scavenger hunt. "The book contains practical and accessible interventions that many children could benefit from," says an expert from the Child Mind Institute. "The information is presented in an easy-to-understand and fun format. Overall, it's a self-help book that kids will enjoy." Ages 8-12. Published by Sky Pony Press.
Written by Gibson Frazier, illustrated by Micah Player

This must-read for children who have trouble with impulse control highlights a clever technique to help manage behavior. Dash says he knows right from wrong, but that doesn't stop him from blowing out the candles on his friend's birthday cake and breaking his grandma's cookie platter. "In the story, Dash learns a grounding exercise that helps him stop and relax before he takes action," says an expert from the Child Mind Institute. When Dash is tempted to fly a paper airplane in class, "the reader is able to see the difference that the grounding exercise makes with his choice." Bonus: Dash's dad takes him to fly paper airplanes after school, highlighting that there's an appropriate place for the behavior. Ages 4-8. Published by G.P. Putnam's Sons Books for Young Readers.
Written and illustrated by Keith Negley

The witty illustrations in this book may be even more powerful than the text. Kids will see various "tough guys" showing emotion. An astronaut in space holds a picture of his family. A wrestler cries in the locker room. A tattooed biker regrets running over a squirrel. The final image of a father and son is particularly heartwarming. Ages 3-6. Published by Flying Eye Books.
Written and illustrated by Molly Bang

Popular children's books about grief, loss, and learning to heal.
Written by Steffanie Lorig and Rosalie Frankel

This 40-plus-page activity book uses writing and drawing to help kids work through their emotions. Activities include creating a "Circle of Strength" and using a calendar to express feelings on different days. "I use this book in therapy for grieving children and find it to be extremely effective," says an expert at the Child Mind Institute. Ages 6-10. Published by Art With Heart.
Written by Pat Thomas, illustrated by Lesley Harker

This book explains, in realistic but reassuring language, why people die and how hard it can be to say goodbye. The real genius: "What About You?" boxes scattered throughout the book that contain questions you can ask children. "I particularly like that it normalizes the sad feelings around death," says an expert at the Child Mind Institute. Ages 4-8. Published by B.E.S. Publishing.
Written by Patrice Karst, illustrated by Joanne Lew-Vriethoff

This companion book to The Invisible String focuses on the death of a pet. When Zach's beloved dog dies, he's sad and angry. Zach's friend Emily tells him, "When pets aren't here anymore, an invisible leash connects our hearts to each other forever." Although skeptical at first, Zach begins to feel his dog's presence. The concept of an invisible string "is a mental and visual way to recall positive memories," says an expert from the Child Mind Institute. Ages 4-9. Published by Little, Brown Books for Young Readers.
Written by Patrice Karst, illustrated by Joanne Lew-Vriethoff

This bestselling picture book introduces little ones to the concept of an invisible link between people, even when they're separated. In the story, a mom explains to her children that there is a "very special string made of love" that connects them to everyone they love. "When you're at school and you miss me, your love travels all the way along the string until I feel a tug on my heart," Karst writes. The story continues with explaining how far the string reaches - to a submarine captain in the ocean, a dancer in France, and even to a beloved relative in heaven. Ages 3-8. Published by Little, Brown Books for Young Readers.
Written by Holly Thompson, illustrated by Ashley Crowley

After Kai's dad died, the boy's grief manifests itself in many ways, from crying to throwing a fit to feeling flat and robotic. "The story line shows the change from struggling to recovering, and emphasizes using support networks," says an expert at the Child Mind Institute. Ages 4-8. Published by Albert Whitman & Company.

In this tender tale about the loss of a pet, a black cloud forms over the head of a girl whose beloved dog, Pumpkin, has recently died. She cries so hard that she feels like there's soap in her eyes and an octopus has wrapped itself around her heart. Then she dreams that Pumpkin licks the soap from her eyes and barks at the octopus. That's when she realizes that Pumpkin will always be with her. "This book ties physical symptoms to grief and discusses always having the memories," says an expert at the Child Mind Institute. This book is available in both English and Spanish language versions. Ages 4-8. Published by NuboOcho.

Following a fire at their castle home, a girl in a red cape and her fox navigate an arduous and frightening journey before reaching a bright future. Stunning illustrations and short, rhyming text convey a powerful lesson. "For children at different stages of grief, this book includes a message of hope that after the pain, things will get better," says an expert from the Child Mind Institute. Ages 3-7. Published by Candlewick Press.
Written and illustrated by Laurie Krasny Brown and Marc Brown

Popular children's books on finding identity and appreciating differences.
Written and illustrated by Michael Hall

Popular children's books on neglect and how caregivers should act.

Written by Lauren H. Kerstain, illustrated by Natalia Moore A licensed social worker crafts a compelling and authentic story about what it feels like for a child who has lived in a lot of foster homes. When Calvin moves in with Maggie, he doesn't want to unpack his suitcase or get a goodnight hug. He accidentally breaks things multiple times, testing Maggie's patience. But she always responds with kindness and wise advice. The ending is heartwarming. "This book provides an example of building a warm relationship with a caregiver while honoring a relationship with a biological parent," says an expert from the Child Mind Institute. Ages 4-9. Published by Magination Press.
Written by Susan Farber Straus, PhD, illustrated by Claire Keay

Written and illustrated by Beth Richey and Paula Wood

In a calm, reassuring tone, two trauma therapists explain the things that children should be able to count on from the grown-ups they belong to -basic needs, such as food, a home, schooling, safety, and love. Sometimes the adults can't provide these things, the book notes, and the kids need to be cared from by someone else. Soothing illustrations of animal characters help put children at ease, and they are assured that they deserve to have everything they need to be healthy and happy. "Using direct, child-friendly language, the book is particularly helpful for kids who see Children Protective Service workers or lawyers," says an expert from the Child Mind Institute. Ages 4-8.Published by Warren Publishing.

Popular children's books on OCD and related disorders.
Written by Elly Swartz

In this moving chapter book, 12-year-old Molly Nathan struggles with undiagnosed obsessive-compulsive disorder as she navigates middle school friendships and life without her mom, who has temporarily relocated for a job. Early on, many of Molly's OCD tendencies - like organizing takeout menus alphabetically and looking for the patterns in phone numbers - are casually woven into a story line that focuses on her desire to win the poetry slam so her mom will come home for the banquet. But, as time passes, her OCD worsens: "I used to just wash my hands, and then I started washing my hands a lot, and now I scrub them raw," Swartz writes. When Molly becomes fixated on counting, her dad takes her to a doctor who provides her diagnosis. Ages 9-14. Published by Farrar, Straus and Giroux.
Written and illustrated by Veronica Agarwal and Lee Durfey-Lavoie

Maggie, a sixth grader, tries to live up to her older sister's achievements in this graphic novel that spotlights anxiety and obsessive-compulsive disorder. When she comes home from school, Maggie goes through a ritual of switching the lights on and off. She also rolls a 20-sided die to help her make decisions. Although she resists therapy at first, she eventually goes. "Maggie comes to terms with her behavior, puts a name to it, and copes with it," says an expert from the Child Mind Institute. References to Dungeons and Dragons as well as anime help engage reluctant readers. Ages 8-12. Published by Random House Graphic.
Written by Holly L. Niner, illustrated by Greg Swearingen

Before he goes to sleep, Kevin asks his mom the same questions over and over and lines things up neatly so "his mind doesn't get sweaty." By the end of the story, Kevin's OCD has improved thanks to therapy and medication. Ages 7-12. Published by Albert Whitman & Comp a ny.
Written by Wesley King

This YA book combines a coming-of-age tale with a mystery novel. The protagonist is 13-year-old Daniel, who hides his "zaps" - rearranging cups into geometric patterns, tying his shoes a lot, and counting things - from other kids at school and at football practice. Written in the first person, "this book does an excellent job of describing the stigma and has a very accurate description of how obsessions and compulsions take hold," says an expert at the Child Mind Institute. Eventually, Daniel discovers that he has OCD, moves toward self-acceptance, and helps a friend solve a mystery. Ages 12+. Published by Simon & Schuster/Paula Wiseman Books.
Written by Aureen Pinto Wagner, PhD, illustrated by Paul A. Jutton

Popular children's books on self-esteem and celebrating our differences.
Written by Allia Zobel Nolan, illustrated by Miki Sakamoto

This collection of six stories, published exclusively in Spanish, is designed to increase a child's self-esteem. "The book has great visuals and provides suggestions for parents and teachers," says an expert at the Child Mind Institute. Ages 7-9. Published by Beascoa.

Popular children's books on selective mutism and learning to speak in public.
Written by Dr. Melissa Giglio and Daisy Geddes Illustrated by Ira Baykovsk

This sweet, rhymed story is about a little girl who is lively and boisterous at home but freezes up and can't speak when she's at the playground or at school. Her parents encourage her to try "brave talking" and she practices until her confidence swells and her words flow. "It introduces facing fears by taking small steps and illustrates how it takes practice to build brave muscles," says a selective mutism expert from the Child Mind Institute. Ages 4-8. Published by Brave Mighty Minds.
Written and illustrated by Elaheh Bos

Written by Julie Mensh Graham

This tells the story of a turtle with selective mutism whose friends are patient and take the time to interact with her without putting pressure on her to speak. "This gives her a chance to relax and get comfortable enough to use her brave voice," notes a Child Mind Institute expert. "Helpful strategies for kids with SM, as well as for their family and friends, are woven into the narrative."Ages 3 and up. Published by Nightingale Books

Popular children's books on sensory processing and finding courage.
Written by Sally J. Pla, illustrated by Steve Wolfhard

Popular children's books on tourette's syndrome and related disorders.
Written by Ellie Terry

Toggling between verse and prose, this book is written from the points of view of two students: Calli, who has Tourette's Syndrome, and her classmate Jinsong. Most students tease and reject Calli because of her tics. "I walk into the boys' locker room, and all I hear is: 'The new girl wears old clothes. The new girl rolls her eyes. The new girl makes creepy sounds with her throat," says Jinsong. "It's all true. But somehow it feels wrong to hear them say it." Readers will be satisfied by the end of the story when Calli begins to stand up for herself and find confidence, says an expert at the Child Mind Institute. Ages 8-12. Published by Square Fish.
Written by Dusti Bowling

Popular children's books covering trauma and helping children understand traumatic experiences.
Written by Margaret M. Holmes, illustrated by Cary Pillo

When Sherman, a raccoon, saw something that upset him, he became nervous, didn't sleep well, and felt sad. "Through Sherman, the book explains the symptoms of post-traumatic stress disorder in simple terms that young children can understand," says an expert at the Child Mind Institute. "The book also covers the importance of talking about traumatic things to help feel better." Another plus: The story doesn't specify exactly what happened to Sherman, so the book could be useful in many situations. Ages 5-9. Published by Magination Press.
By Kimberly Brubaker Bradley

During World War II, 10-year-old Ava escapes her traumatic life with her mom and goes to the countryside, where she learns to ride a pony and read. But in the country she is still struggling with post-traumatic stress disorder; for instance, going into a bomb shelter reminds her of being locked in a kitchen cabinet in her mom's apartment. Because of some mature language and themes, it's better read with your child. Ages 9-12. Published by Puffin Books.
Written and illustrated by Beth Richey and Paula Wood

Two social workers team up on this book for children who have experienced physical abuse. Using cute illustrations of animals, the book explains that it's not okay for a grown-up to hurt a child, no matter what the child has done. It also acknowledges that children may have conflicting feelings about the person who hurt them. "The book uses direct and child-friendly language," says an expert from the Child Mind Institute. "It also does a good job explaining what abuse means." Ages 4-8. Published by Warren Publishing.

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77 Children's Books About Mental Health - Child Mind Institute

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Explore our favorite children's books on everything from ADHD to trauma. Help your kids understand the emotional and learning challenges they may be experiencing.

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infant and early childhood mental health

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what mental health issues in young children look like

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What do mental health issues in young children look like?

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Babies and toddlers can and do suffer from mental health problems caused by trauma, neglect, biological factors, or environmental situations.

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Emotionally Healthy Spirituality for Kids

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Emotionally Healthy Spirituality for Kids

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Emotionally Healthy Spirituality for Kids: Nurturing Heart and Soul

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Emotionally Healthy Spirituality for Kids: Nurturing Heart and Soul Amanda Suarez, Uplift Kids cofounder, told a story on the Uplift Kids podcast about how she developed emotionally healthy spirituality as she grew up. She says: I grew up in a culture that prided itself on happiness. “We’re happy people,” they’d say with bright smiles. So […]

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EMDR for Kids provides resources, tools, and training to help therapists, parents and children of all ages overcome trauma & adversities.

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Helping Children Cope After a Traumatic Event

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Helping Children Cope After a Traumatic Event

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Child Mind Institute Guide - Helping Children Cope After a Traumatic Event

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Helping Children Cope After a Traumatic Event

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Your comfort and support can help children cope with trauma. Advice from the Child Mind Institute on how to what to do and what to look out for.

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When people think of trauma, they often imagine a specific, distinct experience - a frightening accident, a natural disaster, or an experience of violence. And it's true that going through any very upsetting or life-threatening experience (or watching a loved one do so) can lead to post-traumatic stress disorder (PTSD) and other mental health challenges.

But trauma experts increasingly recognize that there's another form of trauma that involves prolonged, repeated experiences and symptoms that often look different from PTSD. This is most commonly known as complex trauma.

Children who have gone through complex trauma often experience profound challenges as a result, and their symptoms are frequently misunderstood. Knowing the signs of complex trauma and understanding how it affects kids can go a long way toward getting them the support they need.

Complex trauma isn't a diagnosis, but rather a concept that describes how chronic upsetting and dangerous experiences impact people, especially children.

"It's a more fundamental change," says Jamie Howard, PhD, a clinical psychologist and the director of the Trauma and Resilience Service at the Child Mind Institute. "A typical trauma might really shake up your schema of how the world works. With complex trauma, it affects how the schema is developed in the first place."

Complex trauma generally stems from chronic, interpersonal negative experiences such as abuse, neglect, or violence in the child's home or community. Because parents or caregivers are often the ones harming the child in situations like these, the child doesn't have the chance to develop a sense of safety and trust in adults. That disruption of the child's core sense of attachment to caregivers is a key element of complex trauma.

"Any kind of trauma can disrupt trust," Dr. Howard says. "But with complex trauma, you don't necessarily develop an ability to trust people in general."

The evidence base for complex trauma is growing, with research indicating that children who have been through trauma that is ongoing and interpersonal in nature tend to have more intense symptoms and behavioral challenges than those who have experienced other forms of trauma.

The development of the concept of complex trauma began several decades ago, when clinicians working with people who had experienced ongoing traumatic events (such as survivors of child abuse) noticed that these people's symptoms were often more varied than the symptoms of PTSD. This distinct set of symptoms became known as "complex PTSD" (CPTSD) and later evolved into a proposed diagnosis termed "developmental trauma disorder" (DTD).

The ideas of complex trauma and DTD developed in large part through the work of the clinician and author Bessel van der Kolk, MD. DTD is not included as a distinct disorder in the most recent diagnostic manual that clinicians use, the DSM-5. But some of the updated PTSD symptoms in the DMS-5 were influenced by the research of Dr. van der Kolk and his colleagues.

To some extent, the symptoms of complex trauma overlap with the symptoms of PTSD. For instance, kids who have experienced complex trauma may experience flashbacks, nightmares, and feelings of emotional numbness.

But with complex trauma, the symptoms are more pervasive. Kids' behavior can look completely unpredictable. "Their lives have been so chaotic that they haven't found a coherent way to organize the world," says Dr. Howard. "And so they look physically and emotionally disorganized and dysregulated. They're not sitting still, they're moving around, they're sort of jumpy. They're a little bit like a live wire."

Children who have experienced complex trauma frequently meet the criteria for a range of different DSM-5 disorders, but there is currently no one diagnosis that captures their typical symptom profile.

However, experts agree that the following symptoms are generally associated with complex trauma:

Challenges with attachment and relationships

Difficulty regulating emotions and behavior

Challenges related to attention span and other cognitive abilities

Dissociation from reality

Low self-esteem

Overall negative outlook on the world

Dr. Howard notes that being in loud, chaotic environments can quickly get overstimulating for kids who have been through complex trauma. "This is when kids start to look like they have ADHD," she says. "Or they might look like they have a severe mental health disorder because their ability to regulate their physiological responses and make sense of the environment is so compromised." Complex trauma is also known to interfere with learning and frequently leads to challenges with behavior and focus at school.

There's no definitive list of the kinds of experiences that can lead to complex trauma. That said, experts generally agree that the events underlying complex trauma usually meet the following criteria:

They are severely negative, such as abuse, neglect, or violence.

They take place over an extended period of time.

They affect the child's ability to relate to others and build trusting relationships with caregivers and other authority figures.

"Complex trauma doesn't have to be physical abuse, but the reason attachment is so affected is because it usually is perpetrated by, or not able to be stopped by, a child's primary caregiver," Dr. Howard says. "And that's what makes it so fundamentally disruptive: the primary caregiver isn't able to provide consistency and safety to the child."

Dr. Howard notes that this kind of disruption can also occur when a parent isn't the one causing the trauma. For instance, kids who are exposed to a lot of community violence might develop complex trauma because their caregivers aren't able to protect them from those dangers, no matter how much they want to.

There isn't yet conclusive evidence about whether certain populations of children are more likely to experience complex trauma. But, says Dr. Howard, "usually this happens in the context of low resources and environments that are stressful overall," which means that children in low-income families may be at greater risk.

Complex trauma can be challenging to treat because, unlike the kind of traumatic event that is typical of PTSD, chronic traumatic experiences may be ongoing even as the child is getting treatment. And most of the research behind evidence-based treatments for trauma symptoms in children is focused on PTSD.

That said, it's still very important for kids dealing with complex trauma to get treatment. The leading treatment for PTSD in children is called trauma-focused cognitive behavioral therapy (TF-CBT), and there is a growing body of research about adapting it for use with complex trauma.

There is also a treatment model known as the ARC Framework that is designed specifically for children who have experienced complex trauma. ARC stands for attachment, self-regulation, and competency, and it focuses on the following goals:

Attachment: Fostering strong connections between kids and their caregivers and creating a safe, supportive environment in which the family can recover from trauma.

Self-regulation: Helping kids learn to identify, express, and manage their emotions.

Competency: Supporting kids' self-esteem and sense of competence, as well as key developmental tasks like executive functions and social skills.

Dr. Howard notes that building a child's secure attachment to trusted adults is at the core of any treatment for complex trauma. "Trauma treatment doesn't involve the abusive parent, if there is one," she says. "To develop an attachment, you need someone who's going to be relatively consistently responsive." This might be another biological parent, a foster parent, a grandparent, or any other reliable caregiver. "What kids need is to form an ability to trust people in this world, to be able to predict how people will respond to them, and have it be appropriate and healthy."

Dr. Howard also points out that when kids don't already have a trustworthy adult in their lives, forming a strong relationship with a trained professional like a therapist or social worker can be another way to rebuild their sense of attachment.

For a child who's dealing with complex trauma, any reliable support from a caring adult can make a big difference. If you're an educator, clinician, or other consistent presence in a child's life, there are ways you can help them even if you're not involved in their formal treatment.

"The first thing is to always take a benign interpretation," says Dr. Howard. "Sometimes we infer adult thinking, we apply it to kids. But these kids aren't trying to push your buttons. They're having a physiological response."

It's helpful to stay as calm as possible and to take steps to avoid retraumatizing the child. "You have to be a little more thoughtful in how you approach them," Dr. Howard advises. "Don't get too physically close to them because they're going to think you're going to hurt them."

She also recommends keeping your tone of voice neutral, even if you do need to set a boundary or establish a consequence for the child's behavior. "If you snap at a child who hasn't been traumatized, it's not going to totally rattle them," she said. "But if you start to raise your voice and look angry at a child who's been multiply traumatized, they don't know what's going to happen. It's like they might duck and cover."

Overall, says Dr. Howard, it's important to try to remember why kids who have been through complex trauma behave in ways that can look confusing and frustrating. "They're doing this because the world is hard to make sense of, and so they're reactive. It's best met with calm, consistent respect to help them to overcome what they've been through."

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What Is Complex Trauma? - Child Mind Institute

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When people think of trauma, they often imagine a specific, distinct experience - a frightening accident, a natural disaster, or an experience of violence. And it's true that going through any very upsetting or life-threatening experience (or watching a loved one do so) can lead to post-traumatic stress disorder (PTSD) and other mental health challenges.

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In the video above, Joan Kaufman, PhD, of the Department of Psychiatry at Yale University, discusses the different stages of trauma-focused cognitive behavior therapy, or TF-CBT, the best evidence-based intervention for children who have impairing reactions to traumatic events. One key insight, she says, is that caregivers and children must work together, and that clear communication and understanding can make all the difference.

Trauma-focused CBT is the treatment that's been developed for children with post-traumatic stress disorder that has the strongest evidence base to date. It has multiple components. The first component is psychoeducation, and it involves both the parent and the child. The first thing is both the parent and the child need to learn what are normal trauma responses. For individuals with a history of trauma who might meet criteria for post-traumatic stress disorder, it can be a very unnerving experience. You frequently have flashbacks, you may hear the perpetrator's voice, you have trouble sleeping, trouble concentrating, you may feel cranky and irritable. And to understand that these are all part of a syndrome, and common experiences for people who have been through the type of things that you went through, in and of itself is therapeutic. And it also helps the parent make sense of what the kid is experiencing, and understanding that trauma triggers often elicit some negative behaviors. So if a child has been exposed to domestic violence, yelling can be a trigger. Running into a perpetrator is often going to elicit extreme anxiety and might also elicit irritability. So starting to get a catalog of what are those things that elicit these symptoms helps you begin to get control of it. So psychoeducation is the first component.

The second is skills-building. Being able to develop a sense of skills to deal with extreme anxiety: Relaxation training, thought-stopping techniques for recurrent memories. And the training and skills the parent wants are, how do I manage the child when they get irritable or they may be oppositional or they don't want to sleep. What are some skills I can use that will help them manage those behaviors and not have things escalate?

Once there's a set of skills and feeling like some sense of mastery, then the next major component is the trauma narrative, which is basically a revisiting of the trauma: Telling the story, and also the cognitions and the thoughts that go along with it. One of the core symptoms of PTSD is avoidance, and there's that sense of, "I'll be fine if I just don't think about it." But the reality is, it comes back, and our experiences shape us. And by taking it out of the box and examining it, it allows us to pack it up and really put it away. If we just shove it in there, you can't really close the suitcase. And it's important that oftentimes when things have happened to you, how you make sense of it affects how you feel about yourself.

I remember one adult saying to me she couldn't remember what she did that made her father want to choke her. And the reality is that there's nothing that justifies a parent choking a child. But yet she had this sense of, "I'm really not worthwhile." And so, taking out and examining what are the thoughts you have as to why things happened, is really - it's called trauma-focused CBT because it does have cognitive behavior therapy elements, where you look at the cognitions and how that affects your emotions and how that affects your behaviors. You make those links and then lots of times you can realize that the way you made sense of the horrible things that happened to you - it's not because you were a bad person, it's not because you deserved it, it's not because you should have been able to stop it and you couldn't have. That you can then put these things away without all those negative thoughts about yourself.

After the trauma narrative is created (and it can be done in multiple ways - actually writing a story, or some children do it with cartoons or drawings), it's something that's shared with the caregiver. And it's a really important process, that these are not experiences and thoughts that are alone in the child's head, but that the parent and the child have a way of talking and communicating about these things.

So over time, TF-CBT has been found to lead to reduction not just in PTSD symptoms, but in behavioral symptoms with these gains really maintained over time. In the state of Connecticut, since we have implemented trauma-focused CBT, the number of kids in the Child Protective Services system needing inpatient psychiatric care has gone down enormously. Before system-wide we were offering this treatment, about 65% of child psychiatric inpatients were kids who were involved in the system due to abuse or neglect. It's now down to about 30%, and I think addressing the trauma symptoms really has allowed an enormous number of children to kind of get back on track and be kids again.

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What's the Best Treatment for PTSD in Children? - Child Mind Institute

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Dr. Joan Kaufman of the Department of Psychiatry at Yale University discusses the four stages of trauma-focused cognitive behavior therapy.

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Being diagnosed with a learning disorder doesn't mean that a child isn't intelligent. Getting an accurate diagnosis can make a huge difference for kids who are struggling with learning, and with the right instruction, they can thrive in school and beyond.

Learning disorders are often noticed for the first time when a child is in preschool or elementary school and has trouble building skills that come more easily to their peers. The signs of a learning disorder vary depending on what the child is struggling with.

Several common learning disorders, including dyslexia, dyscalculia, and dysgraphia, fall under the umbrella of a diagnosis called "specific learning disorder."

Here's a look at different kinds of learning disorders that kids may be diagnosed with, along with their most common symptoms.

Children with dyslexia have an unusually difficult time learning to read. They often struggle with reading new words, sounding out words, recognizing words they've already learned, spelling, and writing. To become strong readers, kids with dyslexia need a particular kind of instruction known as systematic phonics-based instruction.

Signs of dyslexia include:

Struggling to rhyme

Difficulty matching sounds with letters

Trouble putting sounds in the right order

Talking later than other children

Trouble remembering words

Having a hard time following directions

Leaving out little words when reading (like the, and, in) or reading them twice

Difficulty sounding out words they don't know

When kids are diagnosed with dyslexia, their diagnosis is technically called specific learning disorder, with the specification that they struggle with reading.

For more, read our Complete Guide to Dyslexia.

Kids with dyscalculia have an unusually hard time with math. They struggle to understand, learn, and perform math and number-based operations.

Signs of dyscalculia include:

Difficulty recognizing numbers

Learning to count later than other children

Trouble doing math problems

Frequently making small mistakes in math, like being off by one

Confusing basic symbols such as "+" and "-"

Struggling to remember directions

Trouble using numbers outside of school, like remembering a phone number, telling time, or counting out change

When kids are diagnosed with dyscalculia, their diagnosis is technically called specific learning disorder, with the specification that they struggle with math.

For more, read our article on understanding dyscalculia.

Dysgraphia is a learning disability that makes it difficult for children to write. There are two sides to dysgraphia: motor weaknesses that affect the physical process of writing, and cognitive challenges with written expression. Some kids struggle with just one aspect of writing or the other, and some struggle with both.

Signs of dysgraphia include:

Difficulty writing letters, including trouble with forming the letters, spacing them correctly, and making them the same size

Trouble holding a pencil

Writing fatigue, which can mean finding writing tiring or painful

Difficulty with spelling, grammar, punctuation, and sentence structure

Trouble with organization and structure in writing - kids with dysgraphia often have great ideas but struggle to express them in writing

Dysgraphia itself is not an official diagnosis. Children who struggle with the motor skills involved in writing (like forming letters) are often diagnosed with dyspraxia. Those who struggle with the cognitive skills involved in writing (like organizing ideas) are often diagnosed with specific learning disorder, with the specification that they struggle with writing.

For more, read our article on understanding dysgraphia.

Non-verbal learning disorder is a learning disability that causes kids to have trouble recognizing and understanding patterns in body language, visual-spatial information, and other kinds of non-verbal communication. The disorder is sometimes called NVLD or NLD. Kids with NVLD are often good with words but struggle in social situations.

Signs of non-verbal learning disorder include:

Trouble reading non-verbal social cues, such as facial expressions and body language

Difficulty understanding sarcasm

Trouble recognizing other people's emotions

Difficulty understanding visual and spatial information

Seeming clumsy and uncoordinated

Struggling with higher-level math concepts

Talking a lot more than other kids

Trouble breaking down a project into smaller steps

Poor organizational skills

Non-verbal learning disorder is not a formal diagnosis, and not all experts recognize it as a disorder. Its symptoms can sometimes look like those of other disorders, like ADHD or autism. It also varies a lot from kid to kid, so the first step to getting help for a child with NVLD is figuring out exactly what kinds of learning they struggle with.

For more, read our article on understanding non-verbal learning disorder.

Auditory processing disorder is a condition in which kids have trouble managing information that they hear. There is nothing wrong with their hearing, but their brains have a hard time making sense of what they hear. They miss a lot of what is said to them and around them, especially in loud or distracting environments.

Signs of auditory processing disorder include:

Difficulty following spoken directions

Asking for information to be repeated

Trouble telling the difference between words that sound similar (like "bat" and "pat")

Lack of focus, especially in noisy surroundings

Trouble remembering things like nursery rhymes or song lyrics

Mixing up the order of sounds in words or numbers in a sequence (like hearing "48" instead of "84")

Struggling to follow conversations

Auditory processing disorder is not a formal diagnosis, and not all experts recognize it as a disorder. Its symptoms overlap with other diagnoses such as ADHD and learning and language disorders, and many kids with auditory processing disorder also have one of these other disorders.

For more, read our article on understanding auditory processing disorder.

Dyspraxia is a condition that causes children to appear clumsy and uncoordinated compared to other kids their age. There is nothing wrong with their muscles, but their brains have a hard time telling their bodies what to do. Dyspraxia is also known as developmental coordination disorder. Some kids with dyspraxia have trouble with fine motor skills, like using scissors or eating with a spoon. Others struggle with gross motor skills, like catching a ball or riding a bike. Some have issues with both kinds of motor skills.

Signs of dyspraxia include:

In young children, being slow to develop motor skills like crawling, walking, and using utensils

Trouble with fine motor skills like holding a pencil, using a zipper, or fastening buttons

Difficulty balancing

Trouble with physical activities like running and jumping

Frequently stumbling or tripping

Avoiding activities like drawing, writing by hand, or playing sports

As a diagnosis, dyspraxia (or developmental coordination disorder) is technically considered a motor disorder rather than a learning disorder.

For more, read our article on understanding dyspraxia.

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What Are the Different Kinds of Learning Disorders? - Child Mind Institute

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A look at different kinds of learning disorders that kids may be diagnosed with, along with their most common symptoms.

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Multilingual Trauma Resources - Child Mind Institute

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Free trauma resources to aid parents, educators, and other adults in talking to children and adolescents about potentially traumatic events.

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It's increasingly common to hear a child, or an adult, say they have ADHD. But that doesn't mean the disorder is well understood. There is a lot of misunderstanding about ADHD, stemming from the three areas of difficulty it causes for kids - inattention, hyperactivity, and impulsivity - and the fact that a child doesn't have to struggle with all three to get an ADHD diagnosis.

Here are some of the most common myths about the disorder.

Kids are most often diagnosed with ADHD because they have difficulty paying attention in school. And it's called attention deficit hyperactivity disorder. So, many people assume that these kids can't concentrate on anything for more than a few minutes. Caroline Mendel, PsyD, a clinical psychologist in the ADHD and Behavior Disorders Center at the Child Mind Institute, dispels this myth often. She hears parents say, for example, that their child can sit and focus on Harry Potter books for long periods of time, so they must not have ADHD.

"But the truth is if it's something highly reinforcing and engaging for that child, and it's a preferred activity, they will be able to direct their attention to that task," Dr. Mendel says.

Despite the disorder's name, the issue with kids who have ADHD is not actually a deficit of attention but rather a difficulty directing one's attention to things that are not particularly rewarding to them, including instructions from parents and teachers. In fact, many kids with ADHD experience hyperfocus, paying intense attention to things that are interesting to them.

That's why being able to put down the video game and engage in math homework can be a struggle for kids with ADHD.

Again, despite the name, not all kids who have ADHD are hyperactive. There are two presentations of ADHD, explains Dr. Mendel.

If a child has the hyperactive-impulsive presentation, their symptoms include being fidgety and extremely active, as if they're driven by a motor. They also include impulsive behavior -- not thinking before they act. Excessive talking and interrupting, extreme impatience, and trouble playing quietly are all examples of this presentation. This is what a lot of parents think of when they hear ADHD.

But there is also what's called an inattentive presentation. Children in this group get easily distracted and have difficulty focusing on things that require sustained effort, like homework. Other executive functioning difficulties, like forgetfulness and trouble with organization, also fall under this presentation. Hyperactivity is not a symptom here.

"You can have just the inattentive presentation, just the hyperactive-impulsive presentation, or the combined presentation where you have symptoms in both of those areas," explains Dr. Mendel.

"I think that is one of the things that people often don't understand about ADHD. They'll say, 'Well, they're not fidgety,' or 'They're not running around, so I don't think they have ADHD,'" Dr. Mendel says. "I think the 'H' of ADHD can be challenging for some people because not every child with ADHD is hyperactive."

Twice as many boys are diagnosed with ADHD as girls, but that's in part because fewer girls are hyperactive. And hyperactivity is more visible and disruptive than other ADHD symptoms, especially in younger children.

"Typically, boys are more likely to exhibit those symptoms than girls are," Dr. Mendel says. "Girls are much more likely to exhibit inattentive presentation."

Kids who can't stay in their seats or keep from interrupting the teacher are more noticeable than those who are spacey or zoned out in class. That's why many experts think girls with the disorder are overlooked, even though they're struggling in school and often develop self-esteem problems.

Another common symptom in girls that Dr. Mendel sees in her practice is heightened emotional lability. "They have difficulties with inhibiting emotional responses, so they experience feelings in a really big way," she explains. This can present as seeming overly upset over something that seems small, like the end of screen time.

ADHD does change over time, but that doesn't mean it disappears. "An adolescent or adult with ADHD may not be getting up out of their seat, but they may feel internally uncomfortable, jittery, or restless," Dr. Mendel says. The struggle might not be as externally evident.

As kids enter high school, expectations increase. Teens with ADHD can struggle academically, socially, and emotionally. If left untreated, ADHD can lead to impulsive and risky behaviors like drug use and trouble with law enforcement.

About one-third of kids with ADHD will no longer have ADHD symptoms by the time they are adults, Dr. Mendel says. Another one-third will have symptoms of ADHD through adulthood, but they won't be as impairing as they were in childhood. And nearly one-third will have significant ADHD symptoms throughout life.

But Dr. Mendel doesn't encourage parents to wait and hope for their child to grow out of their ADHD symptoms. That's because years of struggling and conflict with teachers and parents can take a serious toll. Recommended treatment includes teaching kids the skills that will help them manage their symptoms all their lives.

"The truth is, they will probably be more likely to succeed if they're getting new skills earlier on and having ADHD treated earlier on," Dr. Mendel said.

It's easy to conclude when a child is impulsive, doesn't follow instructions, and acts out a lot that they haven't been taught to behave at home. But ADHD is a neurodevelopmental disorder, and brain imaging shows differences in the way the brain works in kids with the disorder.

Parenting strategies that work with other kids often don't work with kids who have ADHD, so parents need to adapt. While parenting does not cause ADHD, parents are crucial in helping kids with ADHD learn to manage their behavior.

Parents can clearly express and model what appropriate behavior is and praise their kids for following along. Positive reinforcement is important for building a trusting relationship with parents and in motivating the child to continue the appropriate behaviors.

This proactive structure, often called "scaffolding," provides external regulation of behavior while the child learns to regulate themselves. Behavioral treatment that involves parents and kids can help children with ADHD manage their symptoms both at home and at school.

"In terms of the behavioral parent training, a lot of it is setting up the home environment and the school environment to better respond to and set the child up for success by giving them tools to manage their ADHD," Dr. Mendel says.

Attention deficit disorder, or ADD, is ADHD without "hyperactivity," and some people use it to describe the inattentive presentation of ADHD. But in fact, the term ADD is an older term that has been replaced with ADHD.

People can abuse stimulant medication. And some people think that taking it as a child for ADHD, which doesn't lead to getting high, could be a gateway to substance abuse later in life.

But a host of studies have found that for kids diagnosed with ADHD, taking stimulant medication neither increases nor decreases their risk of addiction to alcohol, nicotine, marijuana, and cocaine.

Unfortunately, kids with ADHD are at a higher risk for substance abuse than other kids. But this is linked to the disorder itself, not the medications used to treat the disorder. Because many kids with ADHD are prone to impulsivity, trouble focusing, and hyperactivity, substances that curb these issues with minimal effort are attractive. The drug can feel like a quick fix to a struggling kid.

And these kids tend to feel the effects of substances more intensely, making them more vulnerable to addiction. So, not addressing and treating ADHD could put a child at greater risk for substance abuse later as they struggle to get a grip on the disorder.

Stimulant medications for ADHD are sometimes said to make children moody or sedated. But that isn't the case with most kids. And if it does happen, it means the child is getting the wrong dose or the wrong medication for their needs.

There is no one-size-fits-all medication regimen for ADHD. Children respond differently to the two different groups of stimulant medications and the different release formulas -- the speed with which medication is released into the bloodstream.

When unwanted side effects occur, it's common to switch medications and formulas.

The dose also matters. For example, if the dosage is too high, the child may begin to seem zombie-like or irritable. If that happens, the medication needs to be adjusted.

But there is a small group of kids with ADHD who do become moody and irritable when they take stimulant medications, even at the lowest effective dose. For these kids, other treatment options, including non-stimulant medications, should be explored.

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Common ADHD Myths - Child Mind Institute

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It's increasingly common to hear a child, or an adult, say they have ADHD. But that doesn't mean the disorder is well understood. There is a lot of misunderstanding about ADHD, stemming from the three areas of difficulty it causes for kids - inattention, hyperactivity, and impulsivity - and the fact that a child doesn't have to struggle with all three to get an ADHD diagnosis.

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While ADHD is believed to be hereditary, effectively managing your child's symptoms can affect both the severity of the disorder and development of more serious problems over time. Early intervention holds the key to positive outcomes for your child. The earlier you address your child's problems, the more likely you will be able to prevent school and social failure and associated problems such as underachievement and poor self-esteem that may lead to delinquency or drug and alcohol abuse. Although life with your child may at times seem challenging, as a parent you can help create home and school environments that improve your child's chances for success.

Here are some ways to get started.

Don't waste your limited emotional energy on self-blame. ADHD is a disorder in certain areas of the brain and is inherited in the majority of cases. It is not caused by poor parenting or a chaotic home environment, although the home environment can make the symptoms of ADHD better or worse.

Learn all you can about ADHD. While a great deal of information on the diagnosis and treatment of ADHD is available, not all of it is accurate or based on scientific evidence. It is up to you to be a good consumer and learn to distinguish the accurate information from the inaccurate. How can you sort out what will be useful and what will not? In general, it is good to be wary about ads claiming to cure ADHD. Currently, there is no cure for ADHD, but you can take positive steps to decrease its impact. In addition, pay attention to the source of the information. If you're using the Internet, stick with reputable websites such as government (for example CDC), nonprofit (such as CHADD) or university resources (those that end in .edu).

Make sure your child has a comprehensive assessment. To complete the diagnostic process, make sure your child has a comprehensive assessment that includes medical, educational and psychological evaluations (involving input from your child's teacher) and that other disorders that either mimic or commonly occur with ADHD have been considered and ruled out.
How to help your child succeed at school

Become an effective case manager. Keep a record of all information about your child. This includes copies of all report cards, teacher notes, disciplinary reports, evaluations and documents from any meetings concerning your child. You might also include information about ADHD, a record of your child's prior treatments and placements and contact information for the professionals who have worked with your child.

Form a team that understands ADHD and be the team captain. Meetings at your child's school should be attended by the principal's designee as well as a special educator and a classroom teacher that knows your child. You, however, have the right to request input at these meetings from others that understand ADHD or your child's special needs. These include your child's physician, the school psychologist, and the nurse or guidance counselor from your child's school. If you have consulted other professionals, such as a psychiatrist, psychologist, educational advocate or behavior management specialist, the useful information they have provided should also be made available at these meetings. A thorough understanding of your child's strengths and weaknesses and how ADHD affects him or her will help you and members of the team go on to develop an appropriate and effective program that takes into account his or her ADHD.

Learn all you can about ADHD and your child's educational rights. The more knowledge you have about your child's rights under the two education laws, the Individuals with Disabilities Education Act (IDEA) and Section 504 of the Rehabilitation Act, the better to maximize his or her success. Each state has a parent technical assistance center that can help you learn more about your child's rights (visit http://www.parentcenterhub.org/ptacs/ to find the center in your state).

Become your child's best advocate. You need to represent and protect your child's best interest in school situations, both academic and behavioral. Become an active part of the team that determines what services and placements your child receives in an Individualized Education Plan (IEP) or Section 504 plan. See Education for Individuals with ADHD for more information.

Communicate regularly. Adopt a collaborative attitude when working with your child's team-after all, everyone has the same goal, to see your child succeed! Let your child's teachers know if there are some major changes going on in your family since your child's behavior can be affected. Invite the teachers to contact you with any issues or concerns before they become a problem. Having open lines of communication between you and the school will help your child.

How to make life at home easier

Join a support group. Parents will find additional information, as well as support, by attending local CHADD meetings where available. You can find the nearest chapter to your home using the chapter locator.

Seek professional help. Ask for help from mental health professionals, particularly if you are feeling depressed, frustrated or exhausted. Helping yourself feel less stressed will benefit your child as well.

Work together. It is important that all of the adults that care for your child (parents, grandparents, relatives and babysitters) agree on how to handle your child's problem behaviors. Working with a professional, if needed, can help you better understand how to work together to support your child.

Learn the tools of successful behavior management. Behavioral techniques have been widely established as a key component of treatment for children with ADHD. Parent training will teach you strategies to change behaviors and improve your relationship with your child. CHADD offers the Parent to Parent Program, which provides basic education on many facets of ADHD. You can also identify parent training programs in your community through your local parent information and resource center (www.parentcenterhub.org/ptacs/).

Find out if you have ADHD. Since ADHD is often inherited, many parents of children with ADHD discover that they have ADHD when their child is diagnosed. Parents with ADHD may need the same types of evaluation and treatment that they seek for their children in order to function at their best. ADHD in the parent may make the home more chaotic and affect a parent's ability to be proactive rather than reactive.

Parent training will help you learn to:

Provide clear, consistent expectations, directions and limits. Children with ADHD need to know exactly what others expect from them. They do not perform well in ambiguous situations that don't specify exactly what is expected and that require them to "read between the lines." Working with a professional can help narrow the focus to a few specific behaviors, help you set limits and consistently follow through with consequences.

Set up an effective discipline system. Parents should learn proactive-not reactive-discipline methods that teach and reward appropriate behavior and respond to misbehavior with alternatives such as time outs or loss of privileges. Communicate with the other people who care for your child and work to be as consistent with behavioral techniques across settings and caregivers as possible.

Help your child learn from his or her mistakes. At times, negative consequences will arise naturally out of a child's behavior. However, children with ADHD have difficulty making the connection between their behaviors and these consequences. Parents can help their child with ADHD make these connections and learn from his/her mistakes.

How to boost your child's confidence

Set aside a daily special time for you and your child. Constant negative feedback can erode a child's self-esteem. A special time, whether it's an outing, playing games or just time spent with your child in positive interaction, can help fortify your child against assaults to self-worth.

Notice your child's successes, no matter how small. Make an effort to notice when your child is paying attention well or doing what s/he is supposed to be doing. Tell your child exactly what she/he did well. This can improve your child's self-esteem and teach him/her to notice gradual improvements, rather than being too hard on him/herself.

Tell your child that you love and support him/her unconditionally. There will be days when you may not believe this yourself. Those will be the days when it is even more important that you acknowledge the difficulties your child constantly faces and express your love. Let your child know that you will get through both the smooth and rough times together.

Assist your child with social skills. Children with ADHD may be rejected by peers because of hyperactive, impulsive or aggressive behaviors. Parent training can help you learn how to assist your child in making friends and learning to work cooperatively with others.

Identify your child's strengths. Many children with ADHD have strengths in certain areas such as art, athletics, computers or mechanical ability. Build upon these strengths, so that your child will have a sense of pride and accomplishment. Make sure that your child has the opportunity to be successful while pursuing these activities and that his strengths are not undermined by untreated ADHD. Also, avoid, as much as possible, targeting these activities as contingencies for good behavior or withholding them, as a form of punishment, when your child misbehaves.

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While ADHD is believed to be hereditary, effectively managing your child's symptoms can affect both the severity of the disorder and development of more serious problems over time. Early intervention holds the key to positive outcomes for your child. The earlier you address your child's problems, the more likely you will be able to prevent...

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Childhood Depression: What Parents Need to Know

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Childhood Depression: What Parents Need to Know

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It's normal for kids to feel sad, act grouchy, or be in a bad mood at times. But when a sad or bad mood lasts for weeks or longer, and when there are other changes in a child's behavior, it might be depression.

Therapy can help children who are going through sadness or depression. And there are things parents can do, too. Getting the right care can prevent things from getting worse and help a child feel better.

If sadness has lasted for weeks or longer, talk about it with your child's doctor.

How Can I Tell if My Child Is Depressed?

If a child is depressed, parents may notice some of these signs:

Sad or bad mood. A child may seem sad, lonely, unhappy, or grouchy. It can last weeks or months. A child may cry more easily. They may have more tantrums than before.

Being self-critical. Kids going through depression may complain a lot. They may say self-critical things like, "I can't do anything right." "I don't have any friends." "I can't do this." "It's too hard for me."

Lack of energy and effort. Depression can drain a child's energy. They might put less effort into school than before. Even doing little tasks can feel like too much effort. Kids may seem tired, give up easily, or not try.

Not enjoying things. Kids don't have as much fun with friends or enjoy playing like before. They may not feel like doing things they used to enjoy.

Sleep and eating changes. Kids may not sleep well or seem tired even if they get enough sleep. Some may not feel like eating. Others may overeat.

Aches and pains. Some children may have stomach aches or other pains. Some miss school days because of not feeling well, even though they aren't sick.

What Causes Child Depression?

Different things can lead to depression. There is no single cause. Some children have genes that make them more sensitive to depression. They may have other family members who have been depressed.

Some children go through stressful things. Some have faced loss, trauma, or hardships. Some go through serious health conditions. These things can lead to sadness or grief - and sometimes to depression.

Having extra support during and after hard times helps protect children from depression or lessen the effects. But even when they have good support, some children get depressed. Therapy can help them heal, feel better, and get back to enjoying things.

Is Your Child Depressed?

How can parents know what's typical moodiness and when there is a problem? Learn the signs of depression and ways to help your child feel better.

What Is the Therapy for Child Depression?

The therapy for child depression is cognitive behavioral therapy (CBT). Therapists help kids feel welcome and supported. They have kids talk about what they think and feel. They may use stories, play, lessons, or workbooks. These tools can help children feel at ease and get the most from CBT. When possible, a child's therapy includes their parent.

If a child has gone through a loss, trauma, or other difficult events, the therapy will include things that help a child heal from that, too. And if a parent is dealing with their own loss or depression, the child's therapist can help them get the care and support they need.

What Should I Do if I Think My Child Is Depressed?

If you think your child is depressed:

Talk with your child about sadness and depression. Kids might not know why they are so sad and why things seem so hard. Let them know you see that they're going through a hard time and that you're there to help. Listen, comfort, offer your support, and show love.

Set up a visit with your child's doctor. Let your child's doctor know if sad or bad moods seem to go on for a few weeks. By itself, this doesn't always mean a child is depressed. Tell your child's doctor if you have also noticed changes in your child's sleep, eating, energy, or effort. Tell them if your child is dealing with a loss, a big stress, or hardship.

The doctor will do a physical exam. A full exam lets the doctor check for health issues that could cause your child's symptoms. They can also check for depression. Your child's doctor may refer you to a child therapist. The doctor's office might have a child therapist on staff.

Set up a visit with a child therapist. A child therapist (mental health doctor) will spend time talking with you and your child. They will do an in-depth check for depression by asking questions and listening. The therapist can explain how therapy can help your child.

Take your child to therapy visits. The therapist may suggest a few visits, or more. Therapy can take time, but you will see progress along the way.

Be patient and kind. When your child acts moody or difficult, try to stay patient. Talk with your child's therapist about the best ways to respond when your child acts this way. Often, it helps to connect with your child in a calm way, then guide them to better behavior. Instead of feeling bad, this lets kids feel proud of doing better. It lets them see that you're proud of them, too.

Enjoy time together. Spend time with your child doing things you both can enjoy. Go for a walk, play a game, cook, read stories, make a craft, watch a funny movie. Spend time outdoors if you can. These things gently encourage positive moods. They help you and your child feel close.

Date reviewed: September 2021

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Childhood Depression: What Parents Need to Know (for Parents)

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When a sad or bad mood lasts for weeks or longer and there are other changes in a child's behavior, it might be depression. Learn the signs of depression and what parents can do to help their child.

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Emotions can be volatile. They can prompt us to do or say things that are harmful, hurtful, or just plain regrettable - so we do our best to manage, or regulate, them. Self-regulation looks like taking a deep breath and saying, "Please put your Legos away after you finish playing, so I don't step on one" instead of scooping up every Lego in your house and chucking them out the window.

As adults, we practice self-regulation all the time in interactions with our co-workers, friends, and partners. It's not always easy, but we know that it's more effective and productive to talk about what's upsetting us rather than to just react.

But self-regulation is not innate; it's a set of skills everyone must learn. Developmentally, kids are like cars with faulty brakes, born with the capacity to experience every shade of emotion but none of the tools to regulate them.

Co-regulation is a mutual act, an exchange of calm that occurs between two people. But when it comes to adults (who have acquired the cognitive tools to manage their emotions) and children, co-regulation also means helping a child learn how to regulate their own emotions by showing empathy and modeling calmness. Co-regulation does not mean pretending to exist in a state of calm all the time or never getting angry. It means actively managing your own emotions to help kids learn to manage theirs.

Co-regulation is both something you actively do as well as a biological process - it happens in your body. Research shows that we can directly influence certain processes in one another, such as the production of a stress hormone called cortisol. The distress of others - say, a wailing child - can cause us to feel similar distress. And when we remain calm, we can influence the production of hormones in others to help them calm down too.

Co-regulation has recently become a buzzword in parenting circles, but LaKisha Hoffman, MSW, first encountered the concept as an assistant school principal in Richmond, California. "Students would come to me and be like, 'Oh, my teacher did this.' Then the teacher would also come to me and be like, 'Oh, the student did this and this,'" she recalls.

Teachers seemed to find that kids' behaviors set off their own emotions in ways that were difficult to control. "Some teachers were triggered by students getting up and walking around," Hoffman says. "Some were triggered by students who were talking out of turn. Some were triggered by students who were challenging them."

Hoffman, who is now the senior director of School and Community Programs at the Child Mind Institute, could empathize with teachers' frustrations. But she also recognized that, as adults, teachers had a greater responsibility to be aware of their own triggers so they could support and engage with students even when they acted out.

For adults - parents, caretakers, or teachers - co-regulation begins with self-regulation. Everyone is shaped by their own personal experiences. "We're all human," Hoffman says. "Different things set us off as adults. How do we recognize those things? How do we cope, soothe ourselves in those moments? That's the first step."

Hoffman, a former college basketball player, coaches several youth teams. She recognizes that one of her triggers is when a child bounces a ball while she's talking. It's a small thing, but Hoffman knows from experience that it bothers her. "But I can't just be like, 'STOP bouncing the basketball,'" she says. "I can't interact with them like that. I have to be calm in that moment and say, 'Hey, what's happening now? Are you supposed to be bouncing the ball?' I have to build a culture for them to understand why they shouldn't do that."

Humans have evolved stress responses to help us respond to danger, but those responses can be triggered by stress even when it isn't life-threatening. Perhaps you've heard the term fight-or-flight? Other stress responses include freeze and the lesser-known fawn (appeasing someone to avoid conflict). Say your child throws a tantrum in the grocery store because you took their iPad away. So, you give it back to avoid a scene. This is a fawn response. Fawn responses are also common among people who have experienced trauma, such as abuse.

Is your instinct to yell when your child upsets you (fight)? Instead, do you tend to walk away (flight) or are their reactions sometimes so overwhelming that you get mentally "stuck" and shut down (freeze)? Stress responses can become ingrained. But when you can recognize why you react to something that upsets you a certain way, you can find better ways to cope.

The phrase "take a deep breath" is a cliché for fighting stress. But decades of research show that deep breathing has profound effects on the regions of the brain that govern emotion and cognition. We tend to breathe too fast (hyperventilate) when we panic, so techniques to slow breathing can help us calm down. Even a few deep breaths can kick-start the process. Some specific techniques include belly breathing, box breathing, and butterfly breathing - a particularly good exercise to do with kids.

Of course, you can always just gulp in more air, but the purpose of deep breathing is really self-awareness. When we step outside of ourselves and acknowledge that yes, we are in fact quite angry, we are taking the first step toward controlling the anger - or whatever emotion we're feeling.

When adults can identify their own triggers and stress responses, they are better equipped to recognize them in kids.

Emotional dysregulation can look different depending on the person and situation. For a lot of kids, particularly young kids, dysregulation might look like screaming, stomping feet, or pounding fists on the floor. But consider fight, flight, freeze, or fawn. Dysregulation can also look like withdrawing, overcompliance with adults, or an inability to say "no."

And dysregulation can escalate. "If I get worked up and kids are looking at me, then they all get worked up," says Hoffman. "Then we've just got a whole bunch of worked up people. How do we problem solve in that moment?"

The goal of co-regulation is to reverse course, to de-escalate intensifying stress.

Not all co-regulation is conscious. Our bodies and brains can respond to others without us even realizing it. That said, there are actions we can take to cue the process. Much like the way deep breathing sends a message to your brain to calm down, there are things you can do to send a similar message to another person's body.

Whether you're a teacher or a caregiver, it's important to teach kids strategies for calming down, like deep breathing exercises, before you need to reach for them in a crisis. When our emotions are out of whack, we can't easily focus on or process new information because our brains are too busy dealing with the stress.

Let's say a child is having a meltdown. They're collapsed in a puddle on the floor, hiccup-sobbing and struggling to catch their breath. The first thing you need to do is take stock of your own physical reaction - Is your heart beating faster? Do you feel your face getting hot? - and take a few deep breaths. Relax your body, then:

Get on their level. When a child feels overwhelmed, it's tough to help them calm down when you're towering over them. If you can, get close to eye level and look them in the eyes. Research shows that eye contact fosters trust and connectedness. Eye contact can help kids feel safe. But it's also important to note that some kids with autism can be hypersensitive to direct eye contact. so it's best to take your cues from the individual child.

Name their emotion. For example: "It looks like you're really upset, right now." Labeling a child's emotion lets kids know explicitly that you can see what they might be feeling. You're validating the emotion here, not the behavior - it's okay to feel bad. Labeling also teaches them to notice and name their own emotions, which for very young kids is not intuitive.

Change your tone. Be sure to keep your tone calm, and don't raise your voice. Trying your best to sound relaxed can be a powerful disruptor when a child is upset because we tend to imitate the behaviors we see in others. This "mirroring" happens subconsciously, as a product of mirror neurons in the brain. And there is growing evidence that suggests mirror neurons play an important role in how we learn and express empathy.

Give them a hug or a squeeze. When children are extremely dysregulated, they might be sensitive or even averse to touch. But if a child is consenting to touch, it is a potent tool in the co-regulation toolkit. Touching another person can boost their oxytocin levels. Oxytocin, sometimes called the "love hormone," makes us feel good. It also perpetuates its own release, meaning that a hug or a hand squeeze can have a positive effect that outlasts the action itself.

Guide them in a calming exercise. If there is a calming or breathing exercise that the child is familiar with - maybe you learned it together, maybe they learned it in school - suggest you do it together. Don't be deterred if they say no. Say you'd like to do the exercise because it helps you calm down (it's helpful, especially with very young kids, to reinforce what these exercises are actually for) and start doing it yourself. They may just watch you; they may join in. In the end, either outcome is valuable.

We are imperfect beings. We won't always offer the best or most mindful response when we're upset but making the effort to be aware of our own emotions and behaviors sets a powerful example for kids. Whatever your specific process, the most important takeaway of co-regulation is that kids absorb what they see you do - and it may be easier for them to calm down if you show them how to do it. As Hoffman says, "The best way to teach is to model."

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What Is Co-Regulation? - Child Mind Institute

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Co-regulation can help kids learn to manage their emotions but also requires managing your own.

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Your Calm Is Their Calm: Co-Regulation Strategies for Infants and Toddlers

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What does coregulation vs. self-regulation mean for babies and toddlers? Get insight and ideas for emotional regulation activities for kids.

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What is self-regulation & why does it matter?

Most parents would agree that one of their jobs is to help their child learn to manage their feelings. This ability to manage thoughts, feelings and behaviors is called self-regulation.

Self-regulation includes many important skills, such as:

Impulse control (e.g., growing a mental "pause button" on your brain)

Identifying the present emotion and selecting a coping strategy

Organizing and planning behavior to solve problems constructively

Sustaining attention in order to monitor your own and others behavior as you regulate

Children with stronger self-regulation abilities are more likely to perform well in school, have stronger relationships with adults and peers and have fewer behavioral challenges. Clearly, self-regulation is an important skill worth understanding and promoting in our children!

So, how do we as parents and caregivers do this?

Co-regulation leads to self-regulation

While self-regulation refers to an individuals' processes and abilities, this skill set actually develops through the interactions with others. That is, a child first learns to regulate with others and then is gradually able to use these regulation tools more independently. This process of caregivers providing support for kids to develop self-regulation is referred to as co-regulation.

You may be wondering what exactly you should be doing as a parent in order to 'co-regulate' effectively.

Thankfully, research can help guide us. A recent series of research briefs summarized all of the studies on co-regulation. One of the biggest take-aways from this work is that the development of self-regulation is dependent on predictable, responsive, and supportive environments.

Sounds reasonable so far, right?

Yes! But here is where we see lots of misinformation on social media and the internet. The term "co-regulation" has been misinterpreted to mean that parents must stay next to the child during every emotional or behavioral storm. Additionally, we often see claims that co-regulation is all about physical proximity.

Not only is this inconsistent with the actual complex, nuanced and scientific definition of co-regulation, but blindly following this advice can lead to increased emotional storms (and potentially unsafe behaviors) for both parents and children. It can also inhibit the development of self-regulation.

The most common myth perpetuated in social media parenting information is the idea that co-regulation means that your child needs you right beside them through the entirety of each challenging emotion and behavior, no matter their age or the situation, in order to develop healthy emotional regulation skills.

- Helping Families Thrive (HFT)

The emotion regulation bucket

As always, our mission at HFT is to provide accurate, evidence-based information to parents and providers. This means no over-simplification or click bait headlines that scare parents into or out of certain parenting practices. Like with many parenting topics, co-regulation is nuanced. The reality is that co-regulation includes a variety of parent behaviors - including being responsive with interactions much of the time, over time, and with just the right amount of support.

A helpful analogy for co-regulation that came from the aforementioned research brief is the emotion regulation bucket.

Imagine each child has a emotional-regulation bucket. In any given situation where a child needs to regulate their feelings, their bucket is filled by two pitchers. The first pitcher is the child's own self-regulation abilities, and the second is what the parents need to add (the co-regulation pitcher).

How full a child's self-regulation pitcher is depends on things such as age, developmental differences (e.g., ADHD), and life experiences (e.g., trauma). How much is in a parent's pitcher depends on a variety of things, as well, such as parent mental health and environmental supports (e.g., poverty and chronic stress).

As a child learns to calm their inner storms (or tsunamis for some kids!), less caregiver co-regulation is needed. This means the younger a child is, either based on their actual age or their emotional developmental age, the closer caregivers generally need to be to the action. Gradually, we increase the space and pause more before intervening to allow children an opportunity to access their developing self-regulation skills and assess how much, if at all, we need to increase support.

Avoiding extremes is important

As with so many things in parenting, avoiding extremes is important. As we talk about in this post, research has consistently shown that the most ideal parent style is one that balances both high levels of warmth with high boundaries. Similarly, research with anxiety in children shows that anxiety symptoms get worse when parents are too protective or too controlling in response to their child being anxious.

This means that our goal is to avoid sinking to extremes such as warmth without boundaries (permissive parenting) or boundaries without warmth (authoritarian parenting). This same thinking applies to co-regulation. Essentially, we have to take a balanced approach keeping the emotion regulation bucket analogy in mind.

Take a look at the following examples of ways parents accidentally display extreme responses:

Scenario 1: A young child is upset. The parent thinks, "you've gotta learn to buck up" or "they'll get over it" or "I will not reward this anger with attention" and doesn't provide any support, when in fact their child's pitcher is empty. The child simply didn't have the skills to regulate and there was not enough support given via co-regulation.

Scenario 2: A child is upset. The parent swoops in immediately and dumps their entire co-regulation pitcher into the child's bucket. In this case, the child's self-regulation bucket sits there full, but unused. The child has skills, but does not have the opportunity to use and grow their skills.

Scenario 3: For some kids, their emotion regulation bucket is just on fire. They seem to burst into flames with little notice and the flames are HOT! In moments of really big dysregulation, and for kids who tend to get explosive, sometimes parental attempts at co-regulation (such as reasoning with their child) are like fuel on the fire. The child yells louder, perhaps starts to get more aggressive and hits the parent. The parent then attempts to hold the child's arms down which sends the child into a rage, and both parents and child end up yelling or potentially getting hurt. In this scenario, physical proximity and verbal coaching was NOT regulating for anyone.

Scenario 4: A really upset child says, "go away! Give me space! Just leave me alone!!!!" The parent doesn't want to leave the child alone (because they've heard that's "wrong") so they continue to stay right next to their child against their wishes. They wonder if perhaps the child is saying no "but means yes" (does this sound like a familiar "no means yes" message?). This leads to more dysregulation from the child and sends a confusing message about consent. When children use their words (instead of fists) to communicate their needs (including the need for space) we need to show them that we hear them and not slip into a dangerous "no means yes" situation.

What to do instead

Okay, now that we've seen some examples of what NOT to do, let's discuss what parents can do to effectively co-regulate. Interestingly, there are three different categories of co-regulation behaviors, which include: 1. building a warm relationship, 2. having structure and setting limits, and 3. teaching self-regulation. Co-regulation is NOT just cozy corners and cuddles! It's quite nuanced and it actually has more to do with how you support your child outside of heated moments! (For more about effective prevention methods, see this post.)

So where do we start? You cannot implement any of the nuanced co-regulation strategies until you establish this one essential habit. When your child's emotional storm arises, we want you to first pause before responding. Take a breath. Briefly validate. Observe the child's response. Then, adjust as needed, which may include increasing words, touch and proximity, or decreasing these things.

Pause. Breathe. Validate. Observe. Adjust. Repeat.

Let's take a look at what this might look like. In the examples below, the children respond differently to the parental attempts at co-regulation - thus, the parent behaviors are not identical. But, what they share is the PAUSE to avoid responding in a reactive fashion, and instead slow the whole thing down.

Example with Child 1

Child: "It's not fair! I ALWAYS have to clean up and she doesn't!"

Parent: PAUSE and BREATHE.

Child: "I'm NOT doing it!"

Parent: VALIDATE by saying "cleaning is a bummer" while nodding (see this post for more about validating).

Child: "It's SO stupid!" (volume is lower, wiping tears - words didn't seem to escalate things here)

Parent: ADJUST by offering a bit more verbal and physical comfort. Scooch a bit closer, pause, and say "I get it bud."

Child: Sits quietly next to parent and appears calmer.

Parent: OBSERVE. Waits for a couple minutes of regulation and then follows through with "I'm gonna go work on cleaning up my kitchen mess . I'm not so stoked about it, but I'll get it done." (modeling healthy coping aloud). "Let me know when the clothes are in the hamper and we can (next thing to look forward to).

Example with Child 2

Child: "It's not fair! I ALWAYS have to clean up and she doesn't!"

Parent: PAUSE and BREATHE.

Child: "I'm NOT doing it!"

Parent: VALIDATE by saying "cleaning is a bummer" while nodding (see this post for more about validating).

Child: Child mocks, "'cleaning is a bummer' BE QUIET DAD!" (volume increases)

Parent: PAUSE (no added words or increase to proximity)

Child: Continues to rant to self but not escalating

Parent: OBSERVE, wait for a couple minutes of regulation and then follow through with "I'll be in the kitchen working on my cleaning up if you need me."

Child: "I won't need you. This sucks."

Parent: Continue to allow time and space while child calms down. Hold the boundary (child must clean up toys) but wait to re-engage.

As you can see, these two children responded quite differently to an adults' attempts at co-regulation. The beauty in each is that the parent PAUSED. For more on compassionate limit setting, get our Essentials eCourse, or read more about Wise Withdrawals and 4 C's of Limit Setting.

Your parenting mantra when your child's becomes dysregulated: "Pause. Breath. Validate. Observe. Adjust. Repeat. Move forward."

Remember, co-regulation is a skill that develops over time and at different rates for different people depending on their individual wiring and their life experiences. Your child's response to a hug, and "I see you're upset buddy" may be to hug you and feel comforted. Your friend's child may respond to the same co-regulation attempts by becoming more upset. This is not a parenting contest. There is not a one-size-fits-all script.

For more on the nuance of the 3 research-based pillars of co-regulation, see this post. For a comprehensive, step-by-step program on how to implement these (and other) top evidence-based tools, we've got you covered in our Evidence-Based Essentials of Parenting Course!

Remember, at HFT we are all about less shame and more support. Evidence and Balance. You've got this.
References
Rosanbalm, K.D., & Murray, D.W. (2017). OPRE Brief #2017-80. Washington, DC: Office of Planning, Research,
and Evaluation, Administration for Children and Families, US. Department of Health and Human Services.

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Written by Jenna Elgin, Ph.D. & Shanna Alvarez, Ph.D.

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Using Co-Regulation to Build Self-Regulation in Kids - Helping Families Thrive

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The process of caregivers providing support for kids to develop self-regulation is referred to as co-regulation.

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5 Essential Coregulation Techniques for Parents

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Learn how to support your child’s emotional regulation with coregulation techniques. Dive into our blog for valuable insights.

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If you're a parent, chances are you've witnessed a tantrum or two in your day. We expect them in two-year-olds. But if your child reaches school age and meltdowns and outbursts are still frequent, it may be a sign that they have difficulty with emotional self-regulation.

Simply put, self-regulation is the difference between a two-year-old and a five-year-old who is more able to control their emotions. Helping kids who haven't developed self-regulation skills at the typical age is the goal of parent training programs. And many older children, even if they're beyond tantrums, continue to struggle with impulsive and inappropriate behavior.

What is self-regulation?

Self-regulation is the ability to manage your emotions and behavior in accordance with the demands of the situation. It includes being able to resist highly emotional reactions to upsetting stimuli, to calm yourself down when you get upset, to adjust to a change in expectations, and to handle frustration without an outburst. It is a set of skills that enables children, as they mature, to direct their own behavior towards a goal, despite the unpredictability of the world and our own feelings.

What does emotional dysregulation look like?

Problems with self-regulation manifest in different ways depending on the child, says Matthew Rouse, PhD, a clinical psychologist. "Some kids are instantaneous - they have a huge, strong reaction and there's no lead-in or build-up," he says. "They can't inhibit that immediate behavior response."

For other kids, he notes, distress seems to build up and they can only take it for so long. Eventually it leads to some sort of behavioral outburst. "You can see them going down the wrong path but you don't know how to stop it."

The key for both kinds of kids is to learn to handle those strong reactions and find ways to express their emotions that are more effective (and less disruptive) than having a meltdown.

Why do some kids struggle with self-regulation?

Dr. Rouse sees emotional control issues as a combination of temperament and learned behavior.

"A child's innate capacities for self-regulation are temperament and personality-based," he explains. Some babies have trouble self-soothing, he adds, and get very distressed when you're trying to bathe them or put on clothes. Those kids may be more likely to experience trouble with emotional self-regulation when they're older.

But the environment plays a role as well. When parents give in to tantrums or work overtime to soothe their children when they get upset and act out, kids have a hard time developing self-discipline. "In those situations, the child is basically looking to the parents to be external self-regulators," Dr. Rouse says. "If that's a pattern that happens again and again, and a child is able to 'outsource' self-regulation, then that's something that might develop as a habit."

Children with ADHD or anxiety may find it particularly challenging to manage their emotions, and need more help to develop emotional regulation skills.

How do we teach self-regulation skills?

Scott Bezsylko, the executive director of the Winston Prep schools for children with learning differences, says that acting out is essentially an ineffective response to a stimulus. The parent or teacher needs to help the child slow down and more carefully choose an effective response instead of being impulsive.

"We approach self-regulation skills in the same way we approach other skills, academic or social: isolate that skill and provide practice," Bezsylko explains. "When you think of it as a skill to be taught - rather than, say, just bad behavior - it changes the tone and content of the feedback you give kids. "

The key to learning self-regulation skills, says Dr. Rouse, is not to avoid situations that are difficult for kids to handle, but to coach kids through them and provide a supportive framework - clinicians call it "scaffolding" the behavior you want to encourage - until they can handle these challenges on their own.

Imagine a situation that can produce strong negative emotions, like a frustrating math homework assignment. If a parent hovers too much, they risk taking over the regulation role. "Instead of the child recognizing that the work is frustrating and figuring out how to handle it," Dr. Rouse explains, "what they feel is that the parent is frustrating them by making them do it."

Scaffolding in this situation might be helping the child with one problem, and then expecting them to try the rest. If they feel frustrated, they might get up and get a drink. They might use a timer to give themselves periodic breaks. The parent would check in on them at intervals, and offer praise for their efforts.

If a child is prone to melting down when they're asked to stop playing a video game, scaffolding might be practicing transitioning away from the game. "You'd want to practice with a game in which they're not overly invested - you don't want to begin with high-stakes," Dr. Rouse explains. "Have them practice playing for two or three minutes and then handing you the game. They get points towards something they want every time they do it."

Dry runs are another way to scaffold self-regulation. For instance, if you've had trouble with a child reacting impulsively or having a tantrum in a store, make a short visit when you don't need to do serious shopping. Have them practice walking with you, keeping their hands to themselves. They get points towards some goal every time they are successful.

Dr. Rouse says that often parents get discouraged when things don't go well the first time they try skill-building, but consistency and starting at a level that is appropriate for your child are key. Rather than giving up, try paring down the activity so it is more doable, and slowly give your child more and more independence to handle it.

For instance, if brushing their teeth is a problem for your child, you might start by focusing just on putting toothpaste on the brush, and respond with positive feedback and rewards when they do it. Once they've practiced that a few times, add the next step in the chain.

Similarly, if getting out the door in the morning is causing meltdowns, target one step at a time. First, say, getting dressed by 7:15. Once they've mastered that, set a target time for breakfast, and add that. Breaking the chain into small steps allows them to build self-regulation skills in manageable increments.

Help kids become self-reflective

Bezsylko stresses that when parents or teachers approach impulsive, inappropriate behavior calmly and give them time, kids can learn to choose better ways to respond to that situation. The feedback kids need is non-judgmental and non-emotional: what went wrong, and why, and how they can fix it next time.

"When kids are part of an environment that's reflective and analytic as opposed to emotional and fast-paced," Bezsylko explains, "they can learn to make better choices." Slowing down allows children to become more thoughtful, reflective and self-aware. "We need to slow down and model self-reflection and self-awareness and self-regulation for our kids," he notes, "but it's also helpful and good for us, too."

Bezsylko notes that mindfulness and meditation are good for everyone, but especially for children with self-regulation challenges. And Dr. Rouse mentions the many parent training programs available to help them become better coaches for their kids. For older kids, dialectical behavior therapy (DBT) is also an option, as it focuses on distress tolerance and emotion regulation.

At the end of the day, though, nothing can replace the work of the parent. "It seems to me," says Dr. Rouse, "that the family environment is the most important piece."

Frequently Asked Questions

How can I help my child regulate their emotions?

What is self-regulation in child development?

At what age can a child control their emotions?

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How Can We Help Kids With Self-Regulation? - Child Mind Institute

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Tips for helping kids improve their self-regulation skills when they need help to control emotions, handle frustration and resist impulsive behavior. Advice from experts.

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50 Self-Regulation Activities To Empower Your Child To Calm

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50 Self-Regulation Activities To Empower Your Child To Calm

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Self-regulation. Emotional regulation. You want to help your child get to an emotionally calm place when conflict happens. But it is so discouraging when, instead, the conflict spirals out of control.

Have you ever wished you had a go-to list of calming activities for moments of family mayhem? Whether you have a toddler or a teen, try out a few of the activities below. You won't regret prioritizing self-regulation with your kids.
There's a lot of helpful information in this article. Feel free to skip around with the table of contents.
What is self-regulation? How is it different from emotional regulation?

Self-regulation

Self-regulation is the ability to monitor and manage your "arousal state" or energy level. More specifically, it means being aware of your energy level (and basic emotions) that result from either external experiences and/or your internal thoughts. The next step is choosing strategies to adjust your energy level for the most effective response.

Energy self-awareness + healthy coping strategies = SELF-REGULATION

As an adult, this might look like, "I am losin' it!! I'm going to go take a walk and cool down!"With the strong, rhythmical, calming muscle-joint input of walking as you take a brisk walk, you use up the fight/flight chemistry that had started to flood your system. This helps your brain decide "the danger is over" and your frontal lobe begins to function again.
That's self-regulation, and it preps you for the next step: emotional regulation.
Emotional regulation

Emotional regulation is when you understand, evaluate and even problem-solve what you are feeling. Sometimes self-regulation and emotional regulation get mixed up in pop terminology.

Emotional regulation involves the skills to answer these questions:

What am I feeling?

What thoughts or beliefs are driving those feelings?

What is a wise course of action? (i.e. let it go or ideas to solve the problem)

In our example, emotional regulation might be, "Ok, that anger was actually about feeling overwhelmed and out of control. And I'm worried about what's going to happen with my intense oldest. Although things aren't really as bad as they seemed at the time, it would still be good to look for a time to problem-solve this issue with her when we're both relaxed."

This kind of emotional insight is a complicated and often slow process. The brain will shut the process of emotional regulation down in fight-or-flight mode because it (emotional regulation) gets in the way of quick, self protective, fight-or-flight reactions.

So if you want to work through the frustrations of family life, remember this: self-awareness → calming strategy → emotional insight is a vital sequence for both parents and kids.

Energy self-awareness + healthy coping strategies + emotional insight = EMOTIONAL REGULATION

Adults often regulate themselves and don't realize it

Most of us have a go-to strategy when we need to calm down. Those are really important skills to have as a parent, especially when they keep us from "losin' it" with our kids! Deep breaths.

A few minutes in a quiet room away from the chaos.

A phone call to a friend.

A cup of tea.

A funny TV show.

These are self-regulation activities, and you probably know which self-regulation activities help you. Often (thanks to a lifetime of experience) we do these things without even realizing they are helping us calm down!

But for our kids' unstable, developing brains , it's another story...

What happens in fight-or-flight mode and how your child's five senses can help

When your child is having a tantrum their fight-or-flight system has "hijacked" their brain and they have lost control. This does not ignore the role of choice, responsibility and sin in a child's (or adult's) outburst. But for all of us, when needs and stress are high and skills are low, it's very difficult to make a wise choice. Dysregulation is a brain problem. Because of that, you can think of your child's outburst as primarily a brain issue, not a character issue.

In your child's outburst, the blood flows out of the frontal lobe (where emotions are processed) and into the motor cortex and big muscles to prepare him/her for physical self-protection. Even if there's no physical danger, it's the same system.

When a person is in true danger, they cannot stop and consider "Hmmm, what am I feeling right now?" That would slow down quick self-defense reactions, so emotional insight shuts down in fight-or-flight mode.
For a child to grow in emotional regulation and emotional intelligence, they need to calm down enough to get their frontal lobe "back online" and ready to process emotions.
Using the body for self-calming sensory activities

Using the body for self-calming sensory activities does two important things:

1. It uses up the big muscle fight-or-flight chemistry so that it doesn't feed an ongoing anxious state.

2. It taps into the miracle of our sensory systems to signal an "all-clear." Life is calm and pleasant, so the danger must be over.

By helping your kids learn self-regulation skills theirfrontal lobes can resume functioning. Onlythen can they figure out what's going on in them and what to do about it.

Self-regulation needs instruction and practice

For a small percentage of kids, self-regulation comes naturally. For most others, they need a lot of instruction and practice. So don't be discouraged that your children aren't emotional regulation masters!

You've probably experienced trying to get your kids to talk about why they got upset and made a poor choice. But... their brains were still in fight-or-flight mode. What happened?

They mostly likely either shut down or got even more upset. The conversation was anything but a wisdom-building, emotionally regulating discussion!

That's why I'm so passionate about equipping you to help your children learn how to self-regulate.

Why is teaching self-regulation important?

Self-regulation is a stepping stone to emotional intelligence. These two skills will impact your kids' ability to make and maintain lifelong relationships.

This may seem a bit scary if you've got a child that loses their cool easily, blames everyone else, and has little awareness about what was going on in them. But there's plenty of hope!

We now understand that all intelligence, both emotional and cognitive, are malleable. In fact, when caregivers teach kids that kindness is not an innate quality, but can be learned, bullying decreases! Considering all this, it only makes sense that you give your kids the best support in developing their emotional intelligence.

When big emotions sweep over your child, you can help your child learn to calm their body and even name the feeling. It's a valuable opportunity to help your child develop into an emotionally aware and intelligent person who can forge meaningful friendships.

What do researchers say about self-regulation?

In his classic book, Raising an Emotionally Intelligent Child, researcher John Gottman, PhD states:

"...science has discovered a tremendous amount about the role emotions play in our lives. Researchers have found that even more than IQ, your emotional awareness and ability to handle feelings will determine your success and happiness in all walks of life, including family relationships. For parents, this quality of 'emotional intelligence' - as many now call it - means being aware of your children's feelings, and being able to empathize, soothe, and guide them."

Gottman notes that children "learn most lessons about emotion from their parents."

In Emotional Intelligence psychologist Daniel Goleman writes:

"This emotional schooling operates not just through the things parents say and do directly to children, but also in the models they offer for handling their own feelings..."

When your kids are most upset, that's when they need you the most. These challenging situations present a tremendous opportunity to help and equip them to process what's going on inside themselves. Your effort prepares them for successful relationships both now and in the future.

3 stages to consider when your child is unable to control their emotions

There are three developmental stages to consider when teaching your child self-regulation skills:

STAGE 1: Other-regulation

For the first few years, babies and toddlers depend on their caregiver in order to become calm when upset. Parents soothe their fussy, crying infants and toddlers by providing loving sensory input, such as hugging, rocking, providing a pacifier, singing, swaddling, or gentle bouncing. The child regulates, and bonding and trust increase.

STAGE 2: Co-regulation

As the child grows, they begin to "co-regulate" with parents. You and the child participate together in calming activities, and your child absorbs some of your calmness. This might include reading a book before bedtime, taking deep breaths together when upset, or sharing a deep squeeze hug. These activities also develop bonding and trust.

STAGE 3: Self-regulation

Parents can guide their kids to "self-regulate" by encouraging independent, self-calming strategies and activities. By around age six, typically functioning kids can be taught to notice when their energy or emotional level rises and independently use a strategy for calming.

The younger you start with your children the better. However, teaching self-regulation helps older kids as well.

3 examples of parents equipping their kids to calm

Other-regulation:

Harvey Karp suggests five classic strategies in his book and video Happiest Baby on the Block. These are other-regulation activities, where the parents are completely responsible for the input:

But older kids can benefit from other-regulation also, especially if trauma or sensory processing disorder are factors.

Jenna was able to help provide regulation for her 11-year-old daughter who joined their family through adoption by rocking her in a rocking chair. At first her daughter resisted, thinking she was too big or too old. Even though she was almost too big to fit on her mom's lap, she was able to calm with the gentle rocking of the chair and her mom's soothing voice. Once she was calm she was better able to articulate her needs.

Co-regulation:

Julie modeled "dragon breaths" (deep inhale through the nose, blowing a long "fiery" exhale out through the mouth) for her 4-year-old son Ty. Soon, he began to join her. He also began to notice there were times when his mom could benefit from a little deep breathing! 🙂

Tom would sit quietly with his son outside his preschool for a few minutes before dropping him off, which solved the problem of regular anxious outbursts.

When Kelly's teen daughter got upset, they often went for a run together to discuss the conflict, because it was calming and much more productive.

Self-regulation:

Marilyn guided her intense 5-year-old son toward self-regulation by offering choices of calming activities: "If Max gets on a roll, hardly anything stops him. But if I intervene immediately when he's getting wound up, he responds well. I can guide him to do some calm down time in his hammock with music, or do some big muscle/heavy lifting activities. He has improved in his reactions, and I am able to relate to him more calmly."

All the parents mentioned here were able to help each child at different stages on the road to learning self-regulation. They used various calming/self-regulating activities, which strengthened bonding/trust in the relationship, as they avoided escalating outbursts or sending their kids to their room.

What is your child's self-regulation readiness?

Does your child respond best to direct soothing input from you? ("other regulation")

Does your child do well when you do calming activities together? ("co-regulation")

Is your child motivated to avoid outbursts and learn to calm down independently? ("self-regulation")

In any case, when your child's behavior starts escalating, calmly offer help within a few seconds- their brain is flooded with fight/flight chemicals.

Try calming phrases like these:

"I can see this is bugging you. Let's talk about it while we do something fun (or have a snack)."

"Hey Buddy, you're really upset! I can help you."

"What do you need right now? Is there something that can help you feel better so we can figure this out?"

"What will help your body so your thinking brain can work its best?"

"You can try to become calm here with us, or go to a private space to help you feel better. Which do you want to do?"

What if my child resists calming suggestions?

You may be thinking, if I suggest anything when my child is ramping up into an outburst, no way! They'll flat out refuse and get even madder!

You know your child, and you're probably right.

Anything that comes off to your child as, "You're getting upset so you need to do 'x,y or z' to calm down" will almost certainly add fuel to the fire. Your child will feel criticized and controlled and perceive you as a threat, not a helper.

The message that kids who are upset often get from parents is, 'You're mad and I don't really care what you're feeling, I just want peace and quiet." (Ouch. Does that sound familiar?) And who would ever cooperate with that when they're hoppin' mad, right?

No matter what the issue is, an almost sure-fire set up for failure is to try to get kids to do a behavior when they have no motivation and feel manipulated or forced.

One dad's story of not overreacting

One dad told us this story of how his son is learning to self-regulate, by coaching him and not overreacting when he is upset:

"We talk to Gabe about what he wants when he is upset ('do you want a snuggle?') and do not overreact when he is very angry. When we don't over-respond to his outbursts, we can guide him to a quiet place (his room or our bed) where he can look at books, hang out with the cat, or snuggle his stuffed animals until he feels better. Sometimes rubbing his back helps to work out unhappy feelings."

So here's the secret... BUILD MOTIVATION FIRST!

Modeling is the best motivation builder

If you want to maximize children's learning (and cooperation) model this: use sensory activities first with a sincere goal to calm yourself.

Do this on numerous occasions. Let kids know what you're doing and why. Then self-affirm by stating how helpful it was for you.

Don't invite your kids to join you until they've noticed a difference in you! Then when you invite your kids to participate they are much more likely to follow suit, and you can affirm them for their wise choices.

Stated more succinctly, this looks like:

Model, model, model; invite, affirm...

Model, model, model; invite, affirm.

And continue to repeat.

Create pleasant experiences with the activities

Be proactive and have fun trying some of the activities when everyone is calm. activities when everyone is calm. Find out what your kids enjoy.

In order for sensory activities to be calming, they must be pleasant and enjoyable. You can use the term "body treats" when you talk about these activities.

(Side note: Consider letting your kids know ahead of time that if they fake conflict or anger to get a calming toy, snack, or activity, it will no longer be an option. 😉 And although activities should be pleasant, avoid screens as a calming activity because the transition off will be stressful.)

Gradually you can begin to offer activities when your kids are slightly angsty. You might start before a situation (i.e. a transition to the car) or time of day (i.e. late afternoon before dinner) that often escalates into an outburst.

Prepare places and supplies ahead of time

Ask your child to select a "comfy spot" to calm down when upset. You can even use a pop-up tent and stock it with pillows, stuffed animals and a few other favorite (non-screen) items just for that purpose.

For younger kids, prepare picture choices by taking photos of your child practicing calming activities and print them. Then during misbehavior or conflict, show your child a couple of options, and let them choose. The less words you use with an upset child, the better.

Watch for the times when your child naturally self-regulates. Affirm.

For example: "I noticed you were having a lot of arguments when playing with Legos, and you decided to go for a bike ride. It seemed like that really helped you feel better. You paid attention to what your body needed! When you came back the two of you had a great time together."

Affirmation is powerful! When you encourage kids with their small successes, they are usually eager to do more.

You could share Proverbs 15:18, " A hot-tempered person starts fights; a cool-tempered person stops them." Then encourage your child in how they are learning to be a cool-tempered person. You can talk about how that's a blessing to others, and why it's important.

Are you ready to hear some practical ideas you can start using today?

50 calming activities using each of the senses

If you feel out of ideas when life gets messy, don't worry. We've compiled a list of calming activities you can keep in your back pocket. These self-regulation activities help kids use their bodies to calm their brains. They help your child start the emotional regulation process.
PRINTABLE VERSION AVAILABLE HERE
Many of the activities on this list involve motion. A favorite phrase to use that kids can remember is: Motion changes emotion. Feeling sluggish? Get your body moving! Feeling anxious and fidgety? Try some slow deep pressure. How your child uses motion to change emotion can help them learn to self-regulate in a healthy way.

Mouth / oral activities

1. Deep breathing, AKA dragon breaths
2. Cold water in a bottle with a long curly straw
3. Gum (or a popsicle) can be a powerful brain calmer
4. Offer frozen or dried mango slices
5. Fruit smoothie through a straw (suck is calming)
6. Blow on a pinwheel or blow bubbles with a bubble wand (mimics deep breathing)
7. Put a few drops of soap in a bowl and blow bubbles through a straw, or herd "sheep" (cotton balls) with a straw.
8. Blow on a party blower or kazoo (the vibration is calming)
9. Pretend your finger is a candle and practice blowing it out
10. For older kids - "Let's grab some chips and salsa, and we'll talk this through."

A coaching client reported:

"DJ was crying and he specifically asked for the vacuum cleaner activity (an activity in the sensory input video) and said, 'It helps me feel better and not so sad.' After I did it he was so much better and moved on easily. It's fun to see our kids utilizing the Connected Families tools. When one of our kids gets upset, their siblings often try to help them get unstuck by recommending they read a book, take deep breaths, or walk around, telling them 'motion changes emotion.'"

Skin / touch activities

(Many of these activities are included in our sensory input techniques video.)

11. Offer a hug
12. "Squish sandwich" - put pillows or couch cushions under and on top of your child, as they lay face down on the floor and apply pressure. You can even start to talk about whatever is troubling them while they are in this position.
13. Try a weighted blanket
14. Some kids love it when you lay or sit on top of them (of course be careful to regulate your pressure).
15. Rub lotion on each others' hands/skin (or use coconut oil if child dislikes lotions)
16. Make a "calming basket" with fidgets, squishy toys, or calming stuffed animals, and let your child choose things from it. Try searching the internet for "weighted/warmable stuffed animals" meant specifically for self-regulation.
17. Play with the family pet or take a cat/dog cuddle break
18. Back scratches or back rubs before bed
19. Paint each other's nails
20. Finger painting
21. Braiding or playing with each other's hair
22. Play dough
23. A tub or shower
24. Roll child up in a blanket, then pull gently to unroll

Movement-based (vestibular/proprioceptive) activities

25. Do push-ups, relays together by doing a bear walk (on hands and feet, face down), or crab walk (on hands and feet, belly up)
26. Jump on a trampoline
27. Ride a bike around the block
28. Shoot some hoops/play catch/nerf frisbee
29. Play balloon "volleyball"
30. Swing on a swing set
31. Work out on a treadmill/elliptical, etc, if you have one, and talk about how you feel better. Then invite your child to try it. (Please follow safety guidelines if your child is on a piece of your fitness equipment.)
32. Go to the park and do some climbing
33. Turn on kids' favorite music and have a dance party
34. Run up and down the stairs (how fast can kids find the object you hid downstairs?)
35. Make an obstacle course including a collapsible tunnel
36. Bounce on an inflatable exercise ball (or kids hop ball)
37. Bungee "pogo" jumper
38. Make a big pile of pillows and have kids jump onto them from a step stool or couch

How one dad used movement to help his son self-regulate

"After calming down from an early morning ramp up, I was able to speak to Jared while he was in bed. During our conversation about what happened he said, 'It was extra hard to try to be normal this morning.' I asked, 'When it's hard to act normal in the morning, what makes it hard?' He replied, 'I feel squirmy.' I immediately asked him if he wanted to run on Daddy's treadmill, and we were up doing that in the next 30 seconds. He ran a half mile and it was the start of what would be an amazing day!"

Visual activities

1. Calm down jar

2. Color independently or together with your child. This may help less verbal kids identify feelings and wants in their picture.

3. Art, art, and more art

4. Look at books with beautiful pictures/illustrations. You could even buy a book of scenic photography (or look at online photos) and make up stories that could fit the pictures.

5. Build a fort as a safe space that also limits visual stimuli

6. Bubbler toy, or a lava lamp in a dark room

Auditory activities

1. Listen to favorite music (use earbuds or headphones if it helps)

2. Sit outside to listen to the birds and the breeze

3. Hum or sing

4. Use a couple of kazoos (for both humor and vibration to the inner ear) and pretend to "talk out your conflict" through the kazoo with lots of expressions and gestures.

5. Use a white noise machine (on a calming sound) while looking at books

6. Musical instrument box - kids feel in control of their auditory environment when they make music

PRINTABLE VERSION AVAILABLE HERE
What to do after your child successfully self-regulates

When your child calms down, it's important not to just move on ("Glad that's over!"). Instead, be sure to help your child process their big emotions effectively.

This is the first step of EMOTIONAL REGULATION!

Ann Layne, PhD and licensed clinical psychologist specializing in the treatment of anxiety disorders states:

"Research shows that kids who are sent to their rooms to calm down without then processing what was going on in them, aren't practicing emotional-regulation, they are practicing emotional suppression. That causes more problems later."

Processing big emotions to gain emotional regulation skills

After your child is calm, here's how it might go as you can discuss the key questions for emotional regulation:

1. What am I feeling?
Parent/Caregiver: "Would you say you were more mad or hurt when Aidan didn't let you play the game?"
Child: "MAD! He's mean! I don't like him!!"

2. What thoughts or beliefs are driving those feelings?
Parent/Caregiver: "It's really hard to feel left out, isn't it? When that happens to me I don't feel very important. And it hurts my feelings. "
Child: "Yeah. I guess I did feel kind of hurt. He thinks he gets his way just cuz he's bigger."

3. What is a wise course of action? (i.e. let it go or ideas to solve the problem)

Parent/Caregiver: "What do you want to do about it?"
Child: "I dunno. He should get in trouble."

Parent/Caregiver: "I think you can solve this. I could go with you and make sure he listens to you this time. You can tell him how you feel about being left out. Then you guys can figure out a solution you both are ok with. What do you think? Are you ready to talk to him?"
Child: "Sure. If you go with me?"

Parent/Caregiver: "I'd love to help you both figure out a respectful way to talk about this."

"Feel and Deal": How we learn emotional regulation

These kinds of questions above are valuable for equipping a child for a lifetime of productive responses to anger. These aren't just self-regulation (calming oneself) anymore. Now, you're getting at the deeper insights of emotional regulation.

The phrase "Feel and Deal" ("What am I feeling and how do I want to deal with that?") can be a simple prompt to remind both parents and kids about this important process of emotional regulation.

(If you're looking for more resources, Zones of Regulation, or the 5 Point Scale can also help calm an upset child by helping them assess and describe their level of distress.)

Self-regulation and emotional regulation require perseverance, but it's worth it. You are preparing your kids for the inevitable stresses and challenges of life. These are truly skills that can last a lifetime!

For more ideas to connect with your child using movement and play, download our FREE PDF: 60 Ways to Get Kids Moving and Laughing

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Self-Regulation Activities and Games for Kids 

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Self-Regulation Activities and Games for Kids 

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How can you support the development of self-regulation in your child? Check out some of our best activities and ideas here!
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What is Self-Regulation?

When we talk about self-regulation in kids, we're referring to the ability to maintain an arousal level that is appropriate for any given situation. Self-regulation also involves having the ability to generate appropriate behavioral and sensory responses to the input in different situations and daily routines and the ability to demonstrate self control: to monitor and control behavior, attention, motor output, emotions, and social interactions.

Self-regulation skills might include a child maintaining his composure and problem-solving or asking a caregiver for help or guidance when another child takes his toy or being able to self-monitor, control their impulses, and keep their voice quiet in the library. Self regulation in the classroom or school might include a child being able to attend and stay at his desk while the classroom teacher is talking or being able to stay with his class and walk in line in the hallway.

It sounds like a lot, doesn't it? That's because self-regulation is extremely complex. It involves cognition, the sensory systems, behavior...and so much more! Many children struggle with one or more of these areas, making self-regulation challenging. Children who are autistic, who have ADHD, or who need more sensory processing supports may struggle with self-regulation skills more than other kids. Toddlers and kids in the preschool years are still actively developing the ability to regulate themselves and may demonstrate outbursts and tantrums as part of typical development. But all of us - adults and children alike - can have difficulty with managing our own emotions and behaviors when faced with basic daily stressors like tiredness or hunger.

The Self-Regulation Handbook

Here at The Inspired Treehouse, we're so passionate about the topic of Self-Regulation that we finally decided to write a book about it! The Self-Regulation Handbook is an ebook that's packed with tools, activities, strategies, and information that are perfect for supporting self-regulation in kids at home, in the classroom, or during therapy sessions. Click here to learn more!

How Can You Tell if Your Child is Struggling With Self-Regulation?

Recognizing when kids have self-regulation concerns involves recognizing different patterns of behavior. Kids who are having difficulty with self-regulation may:

-Act overly silly or "out of control"

-Have tantrums or meltdowns

-Struggle with transitions between activities

-Have difficulty waiting or taking turns

-Struggle with being in close proximity to others (e.g. circle time)

-Demonstrate problems and frustration during social interactions (e.g. talking too loud, standing too close, touching others)

-Have difficulty walking or waiting in line

-Move too quickly or with too much force

-Grab or touch objects impulsively

How to Help Kids Develop Self-Regulation

Even though self-regulation can be a challenging skill for many children, research has shown that games and fun activities can be effective in promoting better self-regulation and for children who are struggling.

It is also so important for kids to have caregivers who are able to maintain perspective, coach them through difficult situations, demonstrate empathy when kids are struggling with self-regulation, and form responsive relationships that foster kids' self-regulation capacities and self-esteem.

Games and therapy tools that support planning and problem solving, patience, memory, attention, motor control, and sequencing can help kids develop the ability to self-regulate despite challenging situations and circumstances. Calming techniques, self-awareness exercises, and mindfulness activities can also be effective in supporting the development of self-regulation.

The following 30 games and activities can be great ways to introduce self regulation strategies with kids!

Games and Activities for Self-Regulation

The following 30 games and activities can be great ways to introduce and practice self-regulation skills with kids and can even be used as self-regulation interventions during therapy sessions. Click on the linked titles for more information!

1 || Red Light, Green Light

Spice it up with these fun light buzzers! And be sure to check out our post about variations on this classic game to promote self control in kids!

2 || Simon Says

Try this Simon Says parachute game for a different twist on this old classic.

This fun obstacle course for kids is a great way to encourage teamwork and social skills while also working on gross motor skills like balance and coordination!

4 || Duck Duck Goose

A great old classic for working on social interactions, waiting, and more!

5 || Freeze tag

This is an awesome one for working on self-regulation because kids have to wait perfectly still until their friends come to "unfreeze" them.

Cooperative art activities for kids like Partner Painting are perfect for getting little ones to work together while also targeting visual motor and fine motor skills.

7 || Hide and seek

Can kids wait quietly in their hiding spots while their friends try to find them?

Group games for kids like Wacky Relay are a great way to focus on social skills, teamwork, and gross motor skills!

Freeze Dance is so perfect to use in the classroom or at home to practice regulating movements and behavior.

10 || Musical Chairs

We love this idea for working with kids on coping when it's their turn to be "out". It can be a big challenge, but a good way to practice.

The Mirror Mirror game can be as simple, or as challenging as you make it and is a super fun way to address controlled movements and attention.

Working together on controlling the parachute to play different games is awesome for working on self-regulation. Grab our favorite parachute here!

13 || "Counting Down" or Anticipation Activities

Try setting out a beanbag chair and helping the child wait by counting down - "3...2...1...JUMP!" and then jumping onto the bean bag chair. And then repeating the activity so the child knows to wait before jumping)

Bilateral coordination, memory and cognitive skills, and cooperative play are all packed into these fun hand clapping songs and games - and they'll also take you for a little stroll down memory lane!

Hedbanz is another fun game for working on self-regulation because kids have to resist the urge to yell out the picture on their friends' headbands!

16 || Dancing

Kids love practicing their favorite fast and slow dance moves to different types of music - great for regulating speed of movements.

Suspend game is a great fine motor challenge and also challenges kids to regulate the force of their movements.

18 || Balloon volleyball

When kids play balloon volleyball, they have to learn how to slow their movements down in order to control the balloon and not let it go flying!

Slow, careful movements are the name of the game in Jenga and you can modify the blocks to include fun questions and other prompts to boost social interaction.

We like the simple game of Operation for working with kids on coping with turn taking when they hit the buzzer on the pretend patient.

Simon is great way to work on visual attention and memory, this old game is a great one for your classroom or therapy bag.

22 || Sequencing Motor Tasks

For example - do 3 jumps, then 2 hops, then stand on one foot for 3 seconds)

Like Simon, Bop It is great for working on memory, but also includes an auditory processing challenge and an opportunity to learn how to remain calm when kids make a mistake.

Spot It is a perfect game for addressing visual processing skills and also offers kids a chance to cope with "losing" because the rounds go fairly quickly so they can get back "in the game".

These calming deep breathing techniques for kids are great strategies for supporting self-regulation and calm behavior at home, in the classroom, and beyond! Grab the free printable breathing cards too!

These 10 meditation resources are the perfect place to start if you want to try mindfulness activities and guided meditation for kids!

Mindful movement and mindful breathing are a great combination for supporting self-regulation. Try some yoga for kids in your classroom or during your next therapy session!

One of the most popular curriculums on the market for working on self-regulation, Zones of Regulation offers visual supports and practical activities for working on the skills kids need most to regulate themselves.

You'll want these calming techniques in your toolbox for addressing behaviors in the classroom setting.

And these awesome ideas are perfect for taking out into the community to practice self-regulation on the go!

Other Resources About Self-Regulation

1 || Developing Young Children's Self-Regulation Through Everyday Experiences, National Association for the Education of Young Children. Ida Rose Florez

2 || Self-Regulation: A Cornerstone of Early Childhood Development. Linda Groves Gillespie and Nancy L. Seibel. National Association for the Education of Young Children.

3 || Executive Function & Self-Regulation. Center on the Developing Child, Harvard University.

4 || How Can We Help Kids With Self-Regulation? Child Mind Institute.

5 || Strategies for Teaching Kids Self-Regulation. PBS.
6 || Self-Regulation Research: A Simple Overview
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Take Action

Yoga creates a safe, modifiable and inclusive environment for creative, physical movement allowing all participants to be successful. Here are some simple take action steps to get started!

Share the benefits. Yoga and mindfulness practices have a positive impact on kids and learning. Did you know that yoga can help to increase academic readiness? The physical movement and mindful exercises associated with yoga can help to prepare the brain for learning!

Yoga has shown to enhance focus, concentration, comprehension and memory.

The poses help to improve physical fitness by improving posture, balance, coordination, and body awareness.

Yoga can also help to create an atmosphere of confidence, enthusiasm and non-competitiveness where everyone can succeed.

It provides opportunities for reflection, patience and insight, reducing impulsivity and supports social and emotional learning.

Create space and choose a time. Designate a predetermined time for a practice and prepare the classroom environment.

Yoga can be incorporated at any time during the school day. To make it easier, consider the goals of the practice and then pick a specific time of the day to incorporate the routines on a regular basis.

Start with a short 3-5 minute session. Keeping the session short helps the students to stay actively engaged and ready to learn. Add more time as the students become comfortable with a more advanced practice.

Consider turning the lights down, moving items off of desks and tables, playing music, and rearranging any classroom furniture.

Use helpful tools! Facilitators do not need to create yoga-based lessons and activities on their own. There are many amazing and useful tools, books and resources to help you along your journey.

Consider introducing students and staff to yoga through age-appropriate books and stories. When participants know what to expect, the transition to new activities can be less confusing while creating an element of excitement.

Consider using music, yoga deck cards, books and stories, coloring pages, and yoga props.

Plan your lessons with intention. When creating a yoga-based lesson plan, teachers may want to consider the following:

The learning objective of the activity. What do you want the students to know and be able to do? For students to be calmed down, energized, or focused? Let the postures you choose reflect the goals and flow of the lesson plan.

Visualization and mindfulness activities. Through visualization, we invite students to use their imagination. This can help students to release tension and become calmer.
Dedicating a few minutes of your yoga lesson to breath work. You may have heard the saying 'Take a deep breath.' While this is wonderful suggestion based on simple wisdom, it can be harder than you think when you are feeling a little challenged - it's one of the main reasons why we practice it in yoga!

Appropriate yoga postures. Consider the age and developmental level of students as well as other constraints and opportunities.

Peer-peer relationship building opportunities. Brain boosting and creative, community-building games. Yoga doesn't have to always be an individual practice. Consider partner activities, small and larger group games and team-building exercises.

Yoga Poses

While there are many yoga postures to choose from, here are six simple postures that are appropriate for any age or ability level and can be performed without any special equipment or props. Pair these poses with a positive affirmation to help children build confidence and resiliency. Use these in the classroom or at home as a quick and easy practice to stay centered and inspired. Remember to breathe deeply and hold each pose for 3-6 full breaths.

Mountain Pose: Stand with your arms relaxed at your sides with your palms faced outward in a gesture of openness. Stand tall, like a balloon is lifting you up.

Warrior Pose: From mountain pose, step one foot back, slightly angling it outwards, bend your front knee, and bring your arms straight up towards the sky, and look up. Switch sides.

Tree Pose: From mountain pose, transfer your weight to one side. Place the bottom of your left foot on the inside of your right thigh or shin (not the knee) and hold with your palms together at your chest. Switch sides.

Cobra Pose: Lie on your tummy, lift your head and shoulders off ground, place palms flat next to your shoulders, and open your chest.

Cat-Cow Pose: On your hands and knees, tuck your chin into your chest and round your back. Then look up, open your chest, and arch your back. Repeat the Cat-Cow sequence a few times.

Bridge Pose: Lie on your back with your knees bent and your feet flat on the ground. Rest your arms down alongside your body, tuck your chin into your chest, and lift up your hips to create a bridge.

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Take Action

When practicing mindful breathing exercises, it's important to keep in mind that we all process emotions differently, and the practices that we use to help us explore them should be just as flexible.

Use inclusive language. Avoid telling or requiring participation in an activity or following a certain way. Use language that promotes autonomy such as "I invite you to..." or "I encourage you to..." and give children the space to self-select how and when they participate.

For PreK-12 students, avoid holding or retaining the breath, especially with those who are or have experienced trauma. Holding the breath can be a natural response to fear or distress and can be retraumatizing or resurface past traumas. Instead, encourage children to focus on the natural flow of their breath and depth as they breathe into their bellies.

Create space for follow-up. With any exercise that opens up feelings or emotions, it's important to provide space for follow-up. Journaling, group, or private discussion can be a great outlet along with sensory spaces to allow children to process and reflect.

Try out some of these exercises and find a printable toolkit version here.

Deep Belly Breathing: The fullest inhales come from the depth of our bellies - but more often than not, we may find ourselves unconsciously holding our bellies in (especially when sitting). This actually prevents us from breathing fully as it restricts our diaphragm. Diaphragmatic breathing is a simple technique to promote relaxation and mindfulness that focuses on the expansion of the abdomen and diaphragm instead of the chest. This allows us to focus on longer, deeper breathes, rather than short and shallow breaths. Bringing awareness to the rise and fall of our bellies can bring awareness to the quality of our breath and work towards improving.

Sit comfortably and allow the belly to fully relax. Place one hand on your belly and one hand on your heart. On the inhale breath from the very bottom of your belly and feel how your belly expands. On the exhale, bring attention to the feeling of release as your belly falls. Repeat several times, breathing deeper as you go.

Imaginative Exercises: For little ones (or simply to add a playful spin for any age), imaginative mindful breathing exercises pair breathwork with visualization. This can help slow down the breath and bring our awareness in further. Here are some fun examples!
Breathe Upon a Star
Spread your palm out like a star. Trace the outline of your hand with the index finger (pointer finger) on your other hand. Inhale, trace up from the tip of your wrist to the tip of your thumb. Exhale, trace down the other side of your thumb. Repeat - tracing up as you inhale, tracing down as you exhale. Then repeat on the other hand.
Follow the Bead
Imagine a bead on a string. What color is it? What is it made of? What shape is it? Now imagine the string. What color is it? What is it made of? The string now begins to make a shape - any shape. What shape is it? As you inhale, watch the bead move along the string and as you exhale, follow the bead back to where it began.
Blow Out the Birthday Candles
Spread your palm out in front of you. Pretend each finger is a birthday candle. Inhale a deep breath and with a slow exhale, blow out the birthday candles one by one - slowly lowering one finger down at a time while you exhale. Repeat on the other hand.
Bumble Bee Breath
Imagine you are a buzzing bumblebee. Inhale a deep breath in through the nose. With a slow exhale, hum or buzz like a bee. Cup your palms around your ears to amplify the comforting sound and vibration.
Hot Air Balloon (or Bubbles)
Begin by cupping your hands around your mouth. Take a deep breath in through your nose and slowly start to blow out through your mouth, growing your hands outwards in time with your exhale as if you are blowing up an enormous hot air balloon or bubble.

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When a message comes into the brain from anywhere in the body, the brain tells the body how to react. For example, if you touch a hot stove, the nerves in your skin shoot a message of pain to your brain. The brain then sends a message back telling the muscles in your hand to pull away. Luckily, this neurological relay race happens in an instant.

What Are the Parts of the Nervous System?

The nervous system is made up of the central nervous system and the peripheral nervous system:

The brain and the spinal cord are the central nervous system.

The nerves that go through the whole body make up the peripheral nervous system.

The human brain is incredibly compact, weighing just 3 pounds. It has many folds and grooves, though. These give it the added surface area needed for storing the body's important information.

The spinal cord is a long bundle of nerve tissue about 18 inches long and 1/2-inch thick. It extends from the lower part of the brain down through spine. Along the way, nerves branch out to the entire body.

The brain and the spinal cord are protected by bone: the brain by the bones of the skull, and the spinal cord by a set of ring-shaped bones called vertebrae. They're both cushioned by layers of membranes called meninges and a special fluid called cerebrospinal fluid. This fluid helps protect the nerve tissue, keep it healthy, and remove waste products.

What Are the Parts of the Brain?

The brain has three main sections: the forebrain, the midbrain, and the hindbrain.

The Forebrain

The forebrain is the largest and most complex part of the brain. It consists of the cerebrum - the area with all the folds and grooves typically seen in pictures of the brain - as well as other structures under it.

The cerebrum contains the information that essentially makes you who you are: your intelligence, memory, personality, emotion, speech, and ability to feel and move. Specific areas of the cerebrum are in charge of processing these different types of information. These are called lobes, and there are four of them: the frontal, parietal, temporal, and occipital lobes.

The cerebrum has right and left halves, called hemispheres. They're connected in the middle by a band of nerve fibers (the corpus callosum) that lets them communicate. These halves may look like mirror images of each other, but many scientists believe they have different functions:

The left side is considered the logical, analytical, objective side.

The right side is thought to be more intuitive, creative, and subjective.

So when you're balancing your checkbook, you're using the left side. When you're listening to music, you're using the right side. It's believed that some people are more "right-brained" or "left-brained" while others are more "whole-brained," meaning they use both halves of their brain to the same degree.

The outer layer of the cerebrum is called the cortex (also known as "gray matter"). Information collected by the five senses comes into the brain to the cortex. This information is then directed to other parts of the nervous system for further processing. For example, when you touch the hot stove, not only does a message go out to move your hand, but one also goes to another part of the brain to help you remember not to do that again.

In the inner part of the forebrain sits the thalamus, hypothalamus, and

pituitary gland:

The thalamus carries messages from the sensory organs like the eyes, ears, nose, and fingers to the cortex.

The hypothalamus controls your pulse, thirst, appetite, sleep patterns, and other processes in your body that happen automatically.

The hypothalamus also controls the pituitary gland, which makes the hormonesthat control growth, metabolism, water and mineral balance, sexual maturity, and response to stress.

The Midbrain

The midbrain, underneath the middle of the forebrain, acts as a master coordinator for all the messages going in and out of the brain to the spinal cord.

The Hindbrain

The hindbrain sits underneath the back end of the cerebrum. It consists of the cerebellum, pons, and medulla. The cerebellum - also called the "little brain" because it looks like a small version of the cerebrum - is responsible for balance, movement, and coordination.

The pons and the medulla, along with the midbrain, are often called the brainstem. The brainstem takes in, sends out, and coordinates the brain's messages. It also controls many of the body's automatic functions, like breathing, heart rate, blood pressure, swallowing, digestion, and blinking.

How Does the Nervous System Work?

The basic workings of the nervous system depend a lot on tiny cells called neurons. The brain has billions of them, and they have many specialized jobs. For example, sensory neurons send information from the eyes, ears, nose, tongue, and skin to the brain. Motor neurons carry messages away from the brain to the rest of the body.

All neurons relay information to each other through a complex electrochemical process, making connections that affect the way you think, learn, move, and behave.

Intelligence, learning, and memory. As you grow and learn, messages travel from one neuron to another over and over, creating connections, or pathways, in the brain. It's why driving takes so much concentration when someone first learns it, but later is second nature: The pathway became established.

In young children, the brain is highly adaptable. In fact, when one part of a young child's brain is injured, another part often can learn to take over some of the lost function. But as you age, the brain has to work harder to make new neural pathways, making it harder to master new tasks or change set behavior patterns. That's why many scientists believe it's important to keep challenging the brain to learn new things and make new connections - it helps keeps the brain active over the course of a lifetime.

Memory is another complex function of the brain. The things you've done, learned, and seen are first processed in the cortex. Then, if you sense that this information is important enough to remember permanently, it's passed inward to other regions of the brain (such as the hippocampus and amygdala) for long-term storage and retrieval. As these messages travel through the brain, they too create pathways that serve as the basis of memory.

Movement. Different parts of the cerebrum move different body parts. The left side of the brain controls the movements of the right side of the body, and the right side of the brain controls the movements of the left side of the body. When you press your car's accelerator with your right foot, for example, it's the left side of your brain that sends the message allowing you to do it.

Basic body functions. A part of the peripheral nervous system called the autonomic nervous system controls many of the body processes you almost never need to think about, like breathing, digestion, sweating, and shivering. The autonomic nervous system has two parts: the sympathetic nervous system and the parasympathetic nervous system.

The sympathetic nervous system prepares the body for sudden stress, like if you witness a robbery. When something frightening happens, the sympathetic nervous system makes the heart beat faster so that it sends blood quickly to the different body parts that might need it. It also causes the

adrenal glandsat the top of the kidneys to release adrenaline, a hormone that helps give extra power to the muscles for a quick getaway. This process is known as the body's "fight or flight" response.

The parasympathetic nervous system does the opposite: It prepares the body for rest. It also helps the digestive tract move along so our bodies can efficiently take in nutrients from the food we eat.

The Senses

Sight. Sight probably tells us more about the world than any other sense. Light entering the eye forms an upside-down image on the retina. The retina transforms the light into nerve signals for the brain. The brain then turns the image right-side up and tells you what you're seeing.

Hearing. Every sound you hear is the result of sound waves entering your ears and making your eardrums vibrate. These vibrations then move along the tiny bones of the middle ear and turn into nerve signals. The cortex then processes these signals, telling you what you're hearing.

Taste. The tongue contains small groups of sensory cells called taste buds that react to chemicals in foods. Taste buds react to sweet, sour, salty, bitter, and savory. The taste buds send messages to the areas in the cortex responsible for processing taste.

Smell. Olfactory cells in the mucous membranes lining each nostril react to chemicals you breathe in and send messages along specific nerves to the brain.

Touch. The skin contains millions of sensory receptors that gather information related to touch, pressure, temperature, and pain and send it to the brain for processing and reaction.

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If the brain is a central computer that controls all the functions of the body, then the nervous system is like a network that relays messages back and forth to different parts of the body. Find out how they work in this Body Basics article.

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Mindfulness Practices for Indigenous Youth serves Indigenous students grades 6–12 living in McKinley County New Mexico. These young people are participants in Project Venture, an evidence-based, culturally responsive positive youth development program tailored to Indigenous youth. The project aims to co-create culturally responsive mindfulness practices, with the input of an advisory committee of Indigenous elders. … Continue reading “Mindfulness Practices for Indigenous Youth”

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Picture this: you've just picked up your kid from school, and they're in a terrible, horrible, no-good, very bad mood. You want the best for your child and want to help them calm their body down- but you don't want to reach for a screen.

Experts say there are alternatives that can calm your child-and you-in tough situations. They're called somatic exercises, and they can be used to help your child reconnect with their body and breathing so they can find their center again. Read on to see the benefits of incorporating somatic exercises with your children.

What Are Somatic Exercises?

Somatic experiencing, a practice that includes yoga, is a group of exercises that involves being mindful of your body's movements, its feelings, and your breathing. Somatic exercises have been used in hospital settings to treat PTSD, and can be helpful when you're trying to stay centered throughout the day.

Amelia Groves, ERYT-500 and Master Trainer for YogaSix, points out that somatic exercises have been around for thousands of years. "Somatic exercises are movement-based exercises that focus on the mind-body connection in order to integrate thoughts, emotions and physical sensations."

Yoga is the most common somatic exercise we think of, but somatic exercises comprises a full group of mind-body connected exercises, too. Taryn Parker, Director of Curriculum and Training for The Little Gym says somatic exercises are a great way to recognize how your body moves from point A to point B, explaining further: "They're intended to slow us down, not only understanding how we got there, but most importantly experiencing how that made us feel."

For kids, that can be vital. Robyn Parets, founder of Boston-based Pretzel Kids, adds, "With yoga, as with somatic movement, you generally move slowly and pay attention to your body, breath and mind." This can be a real benefit when your kid is feeling disconnected from their body. Bringing them back to breathing and how their bodies feel can help them regulate their emotions.

But adults can also benefit from somatic exercises, says Robyn Gaillard, yoga expert and teacher, healing and wellness practitioner, founder of My Way Om. Intentional body movements encourage your body to rewire from stressed to calm.

What Are the Health Benefits of Somatic Exercises for Kids?

Like other body-mind practices, which have been linked to better concentration and boosted mental health, somatic practices put kids back in touch with how they're feeling.

"Yoga and somatic exercises allow children to connect with their bodies," Parets says. "On a physical level, yoga helps build strength, increases flexibility, and enhances balance. On an emotional level, children can develop an increased sense of self-esteem (for what they can accomplish in their own bodies). Mentally, kids learn skills to calm themselves and regulate their emotions in a healthy way."

The American Academy of Pediatrics (AAP) also recommends yoga for kids, noting that it can help them handle stress and develop mindfulness. Groves adds that kids who have trouble verbalizing their emotions might find somatic exercises helpful. "These practices can be used to regulate emotions, manage mental health, listen to the body's internal signals, and release trauma. Children often do not have the vocabulary to express difficult emotions."

Somatic exercises can help kids express stress and anxiety through their bodies and movement. Plus, Parets says, starting to incorporate these methods will give you some special time with your child, while helping them feel more connected to themselves.

Types of Somatic Exercises to Try With Your Kids

If you're looking to begin your somatic exercise journey with your child, check out some of these easy routines below!

Like in meditation, scanning the body can bring a child a sense of awareness. All they have to do is lie or sit down in a comfortable position, and close their eyes.

"By systematically bringing attention to different parts of the body, from the tips of the toes to the crown of the head, children can explore the sensations throughout their bodies when emotions or thoughts are overwhelming," Groves says.

Parents can practice this kind of mindfulness with their child, giving both parties a sense of calm in stressful situations. "Some children may start identifying (or pointing) at body parts beginning as early as 15 months," Parker points out. "The foundations of body awareness and body comfort can begin [earlier than parents think]."

Helping your kids move through their bodies mindfully can combat distraction in an ever moving and changing world.

Conscious Breathing

When we get stressed, breathing can often speed up or become erratic. Focusing on the breath is an easy way to center our kids. It can help them slow down, says Groves.

"Have your child place a stuffed animal on their stomach and gently rock their friend to sleep using their breath," she suggests. "This helps them become aware of their breath, connect to their body, and calm their nervous system."

They can also imagine blowing out a birthday candle, breathing in gently through the nose, and more forcefully through the mouth.

Practicing some yoga with your kids is another fun way to get them connected to their body, while also incorporating movement. "Yoga poses and sequences, such as sun salutations, are great ways to move through a flowing series of postures," Parets explains.

For kids, start standing with your arms by your sides. Then, stretch your arms skyward, all the way through your fingertips. Bend at the hips, and touch the ground. Come back to standing with your arms by your sides. This simple yoga pose can help your kids feel the whole length of their bodies as they release any stress.

But if they're not feeling movement, that's okay too. "Savasana, deep relaxation pose, isn't really movement-based, however, it is a great pose for kids to relax and focus on their breath," Parets adds. For this yoga pose, all you need to do is lie down and close your eyes.

Opposites Attract Game

Parker, who helps develop curriculum for The Little Gym, recommends this activity for all ages.

"Simply pick a way to move your body in an opposite direction. Get creative-you can move your arms in opposite directions 'in slow motion' or make your body 'small like a mouse' and 'as big as a house.' The key here is expectations and mindfulness."

Lead by example, Parker says, and check in with your kids to see how it makes them feel. As a bonus, this is a great way to transition from one activity to another, sometimes a sticking point for kids.

Outdoor Play

You might be surprised to find that outdoor play is also a somatic exercise. Reconnecting to nature can help kids, and parents, reregulate.

"Unstructured outdoor play is perhaps the best somatic exercise. Children are able to rewire emotional patterns faster when their unstructured play includes movement, climbing, creativity, and imagination," Gaillard says.

For kids who don't want to sit inside when they're stressed, this is a great option. Gaillard adds that laughter, climbing, and running is a great way for your child to reconnect to their body.

Things to Consider Before Doing Somatic Exercises With Your kids

Somatic exercises are an easy way for kids to get back in touch with their bodies, but there are some considerations to keep in mind. Though these exercises can be made as gentle as lying down and as active as free play outside, Groves cautions parents whose children have been through major life trauma to take it slow.

"If there is a history of trauma, it is best to work with a trained somatic therapist to avoid re-traumatizing the child," she says.

Parets adds that children with injuries should also take care when starting a movement routine. "If you are injured, any type of exercise may exacerbate an injury so it's best to discuss with a health care provider prior to participating."

As always, you know your child best. It's important to speak to a pediatrician or health care provider if you believe your child is having trouble regulating their emotions and bodies, or if you suspect there might be underlying issues best resolved with the help of a medical professional.

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5 Easy Somatic Exercises to Try With Your Kids Today

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From yoga to body scans, check out these somatic exercises to try with your kids, straight from the experts.